Impact of the COVID-19 Pandemic on Brain Metastases in Breast Cancer Patients.

Objectives: To evaluate the impact of the COVID-19 pandemic on the diagnosis and treatment delays of brain metastases secondary to breast cancer, and to compare patient demographics, disease characteristics and outcomes before and during the pandemic. Materials and methods: A retrospective study was conducted on 100 patients who were surgically treated for brain metastases in the Neurosurgery Clinic of "Prof. Dr. Nicolae Oblu" Clinical Emergency Hospital, Iasi, Romania. Patients were divided into two groups: pre-pandemic (2018-2020, n=57) and pandemic (2020-2022, n=43). Clinicopathological data, including demographics, metastasis localization, number and duration, were collected and analyzed. Results: The pandemic period saw a shift towards younger patients, with 51% younger than 55 years compared to an average age of 57.9 years before the pandemic. Metastases were mostly located in the parietal lobe (61%). Despite a balanced rural-urban patient distribution, diagnostic delays were observed, with an average metastasis duration of 17 months. Patients from rural areas and older subjects showed tendencies towards later diagnosis. The number of metastases varied, with nearly half presenting a single lesion. Conclusions: COVID-19 pandemic-related disruptions in healthcare services led to delayed diagnosis and treatment of brain metastases, particularly impacting older and rural patients. These findings underscore the need for improved healthcare resilience and equitable access to oncological care to minimize delays and optimize outcomes during public health emergencies.