Psychological impact of the COVID-19 pandemic on breast cancer patients.

PURPOSE: The COVID-19 pandemic uniquely impacted patients with breast cancer as mastectomies were allowed to proceed, yet breast reconstruction surgeries were halted. The purpose of this study was to examine the effect of the COVID-19 pandemic on the rates of breast reconstruction and patients' well-being. METHODS: A chart review included all patients who underwent mastectomy from December 2019 to September 2021. Patients were contacted by a member of the research team and asked to participate in a COVID-19-specific survey and to complete the Hospital Anxiety and Depression Scale (HADS). Patients were then grouped into "surge" or "nonsurge" groups based on the date of mastectomy. RESULTS: Two hundred and fifty-nine patients were included in this study. During the study period, 42% (n = 111) of the patients underwent breast reconstruction. The "surge" group included 106 patients whereas the "nonsurge" group included 153 patients. Fewer patients began breast reconstruction during the surge period compared with the nonsurge period (34.0% vs. 49.0%, p = 0.017). Eighty-six patients participated in the COVID-19 survey. Forty-one percent (n = 35) of the patients felt that their care was disrupted because of COVID-19. Eighty-three patients completed the HADS survey. Overall, 16.8% and 15.7% of the respondents fell into the moderate to severe ranges for both anxiety and depression scales, respectively. CONCLUSIONS: Patients with breast cancer have faced increased difficulties with access to breast reconstruction throughout the COVID-19 pandemic. Our institution demonstrated decreased rates of breast reconstruction and an increase in anxiety and depression. The positive benefits of breast reconstruction cannot be overlooked when determining resource allocation in the future.

Aneurysmal bone cyst of the spine in adult patients: A systematic review and comparison of primary vs secondary lesions.

BACKGROUND: Spine aneurysmal bone cysts (ABCs) rarely occur in adults. Primary and secondary lesions may show some differences and require appropriate treatments. OBJECTIVE: To systematically review the literature on adult spine ABCs. METHODS: PubMed, EMBASE, Scopus, and Web-of-Science were searched. Clinical-radiological features, treatments, and outcomes were analyzed and compared between primary vs secondary adult spine ABCs. RESULTS: We included 80 studies comprising 220 patients. Primary spine ABCs were more frequent (76.4%). Main symptoms were lower-back-pain (42.8%) and motor deficits (31.2%). Tumors were mostly thoracic (31.4%) or cervical (26.8%), showing lytic (70.4%) and/or cystic (52.3%) appearances. Surgical resection (79.1%) was preferred over biopsy (20.9%). Most primary ABCs underwent curettage with bone grafting (62.1%) and laminectomy (39.1%) (P < 0.001), while most secondary ABCs underwent corpectomy (51%) and spine fixation (93.9%) (P < 0.001). Radiotherapy was delivered in 58 patients (26.4%), and embolization in 37 (16.8%). Symptomatic improvement was reported in 91.8% cases, with no differences based on etiology nor extent-of-resection. Median follow-up was 28.5 months, significantly superior in secondary ABCs. Secondary ABCs had significantly higher rates of tumor recurrence (19.2%; P = 0.011) and death (5.8%; P = 0.002). CONCLUSION: Surgical resection, radiotherapy, and embolization are effective in managing adult spine ABCs. Secondary tumors have worse prognoses requiring more aggressive treatments.