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This study assessed the impact of the pandemic on breast cancer (BC) incidence, stage at diagnosis, and management in Belgium in 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All Belgian residents diagnosed with in situ or invasive BC in 2015\u20132020 in the nationwide, population-based cancer registry database were included. Incidence trends for 2015\u20132019 were extrapolated to predict incidence and stage distribution for 2020 and compared with the observed values. National healthcare reimbursement data were used to examine treatment strategies. Exact tumor diameter and nodal involvement, extracted from pathology reports, were analyzed for 2019 and 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>74,975 tumors were selected for analysis of incidence and clinical stage. Invasive BC incidence declined by -5.0% in 2020, with a drop during the first COVID-19 wave (Mar-Jun; -23%) followed by a rebound (Jul-Dec; +7%). Predicted and observed incidence (in situ\u2009+\u2009invasive) was not different in patients\u2009&lt;\u200950 years. In the 50\u201369 and 70\u2009+\u2009age groups, significant declines of -4.1% and \u2212\u20098.4% respectively were found. Excess declines were seen in clinical stage 0 and I in Mar-Jun, without excess increases in clinical stage II-IV tumors in Jul-Dec. There was no increase in average tumor diameter or nodal involvement in 2020. Patients diagnosed in Mar-Jun received significantly more neoadjuvant therapy, particularly neoadjuvant hormonal therapy for patients with clinical stage I-II BC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>BC incidence decline in 2020 in Belgium was largely restricted to very early-stage BC and patients aged 50 and over. Delayed diagnosis did not result in an overall progression to higher stage at diagnosis in 2020. Observed treatment adaptations in Belgium were successful in prioritizing patients for surgery while preventing tumor progression in those with surgical delay. Continuation of monitoring BC incidence and stage in the future is crucial.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13690-024-01296-3","type":"journal-article","created":{"date-parts":[[2024,5,7]],"date-time":"2024-05-07T04:01:58Z","timestamp":1715054518000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Breast cancer incidence, stage distribution, and treatment shifts during the 2020 COVID-19 pandemic: a nationwide population-level study"],"prefix":"10.1186","volume":"82","author":[{"given":"Hanna M.","family":"Peacock","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lien","family":"van Walle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geert","family":"Silversmit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Neven","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sileny N.","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Van Damme","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,5,7]]},"reference":[{"key":"1296_CR1","unstructured":"Sciensano, COVID-19 SURVEILLANCE FREQUENTLY ASKED QUESTIONS. 2022 [updated 20\/10\/2022. https:\/\/covid-19.sciensano.be\/sites\/default\/files\/Covid19\/COVID-19_FAQ_ENG_final.pdf"},{"issue":"1","key":"1296_CR2","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1186\/s12885-022-09292-y","volume":"22","author":"S Jidkova","year":"2022","unstructured":"Jidkova S, Hoeck S, Kellen E, et al. 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Based on the Coordinated Law of 10 May 2015 (art. 138), BCR has a legal task to collect data on cancer, subject it to quality control, process and analyze it, encrypt and store it, report on it, make it accessible for research and protect it. Its activities are monitored and evaluated by the Advisory Committee of Users, an independent committee whose duly qualified members are appointed by law. Secondly, this retrospective study does not fall under the Belgian Law of 7 May 2004 regarding experiments on human persons (art. 3,\u00a7\u00a02). The research on human data for this study was conducted in compliance with the applicable national guidelines. Approval of the Ethical Committee was not necessary for the linkage between data of the BCR and the Intermutualistic Agency (IMA) as in Belgium the Information Security Committee has the authority to approve linkage of secondary health data coming from different data providers (art. 42 Law 13 December 2006). For the linkage between data from BCR and IMA an approval was obtained (art. 39 Law 13 December 2006).Patient consent was waived due to the law stating that the data controller shall be exempt from the obligation to disclose information to the persons whose data are processed where notification to the data subject is impossible or takes disproportionate effort; in particular when data are processed for statistical purposes or for historical or scientific research (art. 14.5, b. GDPR EU 2016\/67).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"66"}}