• Brian L Sprague, Ellen S O'Meara, Christoph I Lee, Janie M Lee, Louise M Henderson, BuistDiana S MDSMKaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington, Seattle, WA, USA., Nila Alsheik, Teresita Macarol, Hannah Perry, TostesonAnna N AANAThe Dartmouth Institute for Health Policy and Clinical Practice and Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA., Tracy Onega, Karla Kerlikowske, and Diana L Miglioretti.
• Office of Health Promotion Research, Department of Surgery, University of Vermont Larner College of Medicine, Burlington, VT, USA; Department of Radiology and University of Vermont Cancer Center, University of Vermont Larner College of Medicine, Burlington, VT, USA. Electronic address: bsprague@uvm.edu.
• Prev Med. 2021 Oct 1; 151: 106540106540.

AbstractThe COVID-19 pandemic disrupted breast cancer screening and diagnostic imaging in the United States. We sought to evaluate how medical facilities prioritized breast imaging services during periods of reduced capacity or upon re-opening after closures. In fall 2020, we surveyed 77 breast imaging facilities within the Breast Cancer Surveillance Consortium in the United States. The survey ascertained the pandemic's impact on clinical practices during March-September 2020. Nearly all facilities (97%) reported closing or operating at reduced capacity at some point during this period. All facilities were open by August 2020, though 14% were still operating at reduced capacity in September 2020. During periods of re-opening or reduced capacity, 93% of facilities reported prioritizing diagnostic breast imaging over breast cancer screening. For diagnostic imaging, facilities prioritized based on rescheduling canceled appointments (89%), specific indication for diagnostic imaging (89%), patient demand (84%), individual characteristics and risk factors (77%), and time since last imaging examination (72%). For screening mammography, facilities prioritized based on rescheduled cancelations (96%), patient demand (83%), individual characteristics and risk factors (73%), and time since last mammogram (71%). For biopsy services, more than 90% of facilities reported prioritization based on rescheduling of canceled exams, patient demand, patient characteristics and risk factors and level of suspicion on imaging. The observed patterns from this large and geographically diverse sample of facilities in the United States indicate that multiple factors were commonly used to prioritize breast imaging services during periods of reduced capacity.Copyright © 2021 Elsevier Inc. All rights reserved.

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