| Autor: |
Tang A; Department of Surgery, University of California San Francisco, Oakland, CA, USA., Neeman E; Department of Medical Oncology, Kaiser Permanente San Francisco Medical Center, San Francisco, CA, USA., Kuehner GE; Department of Surgery, Kaiser Permanente Vallejo Medical Center, Vallejo, CA, USA., Savitz AC; Department of Surgery, Kaiser Permanente Walnut Creek Medical Center, Walnut Creek, CA, USA., Mentakis M; Department of Surgery, Kaiser Permanente South Sacramento Medical Center, Sacramento, CA, USA., Vuong B; Department of Surgery, Kaiser Permanente South Sacramento Medical Center, Sacramento, CA, USA., Arasu VA; Department of Radiation Oncology, Kaiser Permanente Vallejo Medical Center, Vallejo, CA, USA., Liu R; Department of Medical Oncology, Kaiser Permanente San Francisco Medical Center, San Francisco, CA, USA.; Kaiser Permanente Northern California Division of Research, Oakland, CA, USA., Lyon LL; Kaiser Permanente Northern California Division of Research, Oakland, CA, USA., Anshu P; Drexel University School of Medicine, Philadelphia, USA., Seaward SA; Department of Radiation Oncology, Kaiser Permanente Oakland Medical Center, Oakland, CA, USA., Patel MD; Department of Radiation Oncology, Kaiser Permanente South San Francisco Medical Center, South San Francisco, CA, USA., Habel LA; Kaiser Permanente Northern California Division of Research, Oakland, CA, USA., Kushi LH; Kaiser Permanente Northern California Division of Research, Oakland, CA, USA., Thomas ES; Department of Medical Oncology, Kaiser Permanente Oakland Medical Center, Oakland, CA, USA., Kolevska T; Department of Medical Oncology, Kaiser Permanente Vallejo Medical Center, Vallejo, CA, USA., Chang SB; Department of Surgery, Kaiser Permanente Fremont Medical Center, Fremont, CA, USA. |
| Abstrakt: |
Introduction The COVID-19 pandemic drove rapid, widespread adoption of telehealth (TH). We evaluated surgical telehealth utilization and outcomes for newly diagnosed breast cancer patients during the initial pandemic period. Methods We identified patients with breast cancer diagnosed March 17, 2020 through May 17, 2020 who underwent surgery as the initial treatment. Clinicodemographic characteristics were collected. Initial consultation types (office, telephone, or video) were categorized. Outcomes included time to consultation, surgeon touchpoints, time to surgery, surgery types, and reexcision rates. Continuous variables were compared using Mann-Whitney tests or t -tests, and categorical variables were compared using χ 2 or Fisher's exact tests. Results Of 158 patients, 56% had initial telehealth consultations (21% telephone, 35% video) and 42% did not have a preoperative physical examination. Age, race/ethnicity, and stage distributions were similar between initial visit types. Median time to consultation was lower in the initial telehealth group than the office group (6 days vs 9 days, p = 0.01). Other outcomes (surgeon touchpoints, time to surgery, surgery type, reconstruction) were similar between visit types. We observed higher reexcision rates in patients with initial telehealth visits (20% telehealth vs 4% office, p = 0.01), but evaluation was limited by small numbers. The reexcision rate was 13% for patients with telehealth visits and no preoperative physical exam. Discussion During the initial pandemic period, the majority of new breast cancer patients had an initial telehealth surgical consultation. Office and telehealth consultation visits had comparable numbers of postconsultation surgeon touchpoints and most outcomes. Our findings suggest that telehealth consultations may be feasible for preoperative breast cancer consultations. |
