Best Timing for Breast Cancer Surgery after COVID-19 Infection Revealed in New Study

Medical News: Since the outbreak of COVID-19, patients with cancer have faced new challenges in managing their treatment schedules. This issue is especially pressing for breast cancer patients, as surgeries were delayed to minimize COVID-19 exposure risks. However, with COVID-19 now a regular health concern, researchers from the Shandong Cancer Hospital and Institute and Rizhao Central Hospital in China sought to determine the safest time for breast cancer surgery after a COVID-19 infection. This Medical News report explores the findings of this new study, which sheds light on the risks of post-surgery complications when procedures are scheduled too soon after a COVID-19 infection.


Best Timing for Breast Cancer Surgery after COVID-19 Infection Revealed in New Study

Study Goals and Methods
The purpose of the study was to assess the risks breast cancer patients face if they undergo surgery shortly after a COVID-19 infection. Researchers gathered data from 577 patients who tested positive for COVID-19 before surgery, covering the period from December 20, 2022, to March 20, 2023. A control group of 329 patients, who had not been infected with COVID-19 prior to surgery, was selected for comparison.
 
Patients in the COVID-19 group were divided into several categories based on when they underwent surgery after their diagnosis. These groups included patients who had surgery within 2 weeks, between 3 and 4 weeks, 5 to 6 weeks, and 7 to 8 weeks post-infection, as well as those who waited more than 8 weeks. Researchers used statistical tools to analyze complication rates across these groups, focusing on common post-surgical issues such as incision complications and deep vein thrombosis (DVT).
 
Key Findings of the Study
This study found that patients who had breast cancer surgery soon after a COVID-19 infection were significantly more likely to experience complications. Specifically, those who underwent surgery within the first two weeks after testing positive had the highest complication rate, with 17.65% experiencing issues. The complication rate dropped notably for those who delayed surgery by two weeks or more. In comparison, the control group, with no prior COVID-19 infection, had a complication rate of only 3.04%.
 
Patients who had surgery between three and eight weeks after COVID-19 diagnosis still faced a somewhat elevated risk of complications, but the likelihood was substantially lower than for those in the immediate post-infection group. The complication rate for those waiting three to four weeks was 4.59%, while it rose slightly to 8.08% for the 5-6 week group. This suggests that waiting at least two weeks after COVID-19 infection is critical, though longer delays may further reduce risks.
 
The study found that patients who postponed surgery for over eight weeks after a COVID-19 diagnosis had complication rates (2.63%) close to those of the control group. This highlights that waiting longer offers a safer path, especially for patients without urgent surgery needs.
 
Detailed Look at Complication s
The primary post-surgical complications observed were deep vein thrombosis (DVT) and incision-related issues. Patients who had surgery within two weeks of COVID-19 infection had the highest rates of both DVT and incision complications. DVT, a blood clot in the deep veins, was notably common in this group, with an incidence of 11.76%, a stark contrast to the 1.21% in the control group. This trend underscores the increased risk of blood clots for patients who undergo surgery shortly after COVID-19 infection.
 
Similarly, incision-related complications, such as bleeding or poor wound healing, were also more frequent in patients with recent COVID-19 infections. The rate of these complications was 5.88% among patients who had surgery within two weeks of infection, compared to 1.82% in the control group. This aligns with previous findings indicating that recent COVID-19 infection can weaken the body’s immune response, impairing wound healing.
 
Risk Factors and Considerations
While timing was the most significant factor, other variables, including patient age, clinical stage of cancer, and type of surgery, were also examined. However, these factors did not significantly affect the likelihood of complications when controlled for timing. This indicates that timing, rather than patient characteristics, is the primary factor in minimizing complications for breast cancer patients who have had COVID-19.
 
The researchers also looked into the severity of COVID-19 infection, noting that most participants had mild symptoms. However, even mild infections posed a risk of complications if surgery was performed within two weeks. This finding suggests that any level of COVID-19 infection should prompt a delay before surgery, allowing the body sufficient time to recover and reduce the likelihood of complications.
 
Follow-Up and Long-Term Outcomes
The study included a follow-up period of up to 12 months for patients who experienced complications. Researchers noted that all patients, even those with post-surgical complications, recovered without long-term adverse effects. Patients who developed DVT were treated with blood-thinning medications and showed positive outcomes. Those with incision complications also healed fully after receiving appropriate wound care. Importantly, none of the patients with complications faced additional challenges in receiving further cancer treatments, such as chemotherapy, suggesting that while complications may cause short-term issues, they don’t necessarily lead to long-term setbacks.
 
Conclusion
The findings of this study emphasize the importance of timing in breast cancer surgery for patients recovering from COVID-19. To minimize post-surgical risks, it’s best for patients to wait at least two weeks after a COVID-19 diagnosis before undergoing surgery. Those who delay their surgery by eight weeks or more face complication rates comparable to patients who were never infected. This timing approach helps prevent issues like DVT and incision complications, which are more common in early post-infection surgeries.
 
In today’s post-pandemic world, doctors and patients alike need to balance the urgency of cancer treatment with the risks posed by COVID-19. While waiting longer may not always be feasible for urgent cases, these findings support a delay strategy for those who can wait. The overall benefit of this timing approach outweighs the risks, ensuring better outcomes and minimizing the chance of post-surgical complications.
 
For breast cancer patients who’ve had COVID-19, this research offers a guideline for safely scheduling their surgery. Delaying surgery reduces the risk of complications, allowing patients to focus on their recovery and resume treatment confidently.
 
The study findings were published in the peer-reviewed journal: BMC Cancer.
https://link.springer.com/article/10.1186/s12885-024-13080-1
 
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