Sertaç Ata Güler1, Özlem Özkan Güler2, Turgay Şimşek1, Nuh Zafer Cantürk1

1Department of General Surgery, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
2Department of Infectious Diseases and Clinical Microbiology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey


Objective: COVID-19 disease, which rapidly became a pandemic, led to significant changes in the provision of health services. This included radical changes to the supply and delivery of routine services to release resources for emergency care. During this process, a range of restrictions were imposed including the recommended rules to be followed before, during and after surgery. Health services provided for breast cancer diagnosis, treatment and follow-up have also undergone enforced changes meaning the diagnosis, treatment, and follow-up of patients with priority has come to the fore. In this study, the effect of the COVID-19 pandemic in Turkey, between March 11, 2020 and May 31, 2020 was assessed in comparison to pre-pandemic practice in terms of divided into two periods, and breast cancer diagnosis, treatment, and follow-up.

Material and Methods: Surgeons dealing with breast cancer treatment and registered to SENATURK (Turkish Senology Academy) were contacted online. The period was divided into two, between March 11th and April 30th and May 1st to May 31st, 2020. Surgeons were requested to complete two electronic evaluation forms, one for each period, investigating change in practice. Only complete responses for both periods were included in the analysis.

Results: There were 93 respondents. Except for less multidisciplinary breast councils, there was no delay in radiological and pathological diagnoses. The number of breast cancer surgeries increased in Period 2, and more COVID-19 positive breast cancer patients were operated in Period 2. Benign breast patients were delayed less frequently in Period 2. In the statistical analysis performed between the two groups, it was found that only a significant difference was in the number of outpatients with benign breasts.

Conclusion: With sufficient awareness of the risks of COVID-19 and with individual protection, breast cancer treatment was not affected during the assessed period of active pandemic in Turkey.

Keywords: Breast cancer, COVID-19, breast care, breast surgery, disruption

Cite this article as: Güler SA, Özkan Güler Ö, Şimşek T, Cantürk NZ. Changes and disruptions in diagnosis, treatment and follow-up of breast cancer during two periods of the COVID-19 pandemic in Turkey. Turk J Surg 2021; 37 (3): 222-231.


Ethics Committee Approval

This study was obtained from Kocaeli University Non-Invasive Clinical Research Ethics Committee (Date: 03.08.2020, No: 2020/236.

Peer Review

Externally peer-reviewed.

Author Contributions

Concept –S.A.G., T.Ş.; Design – N.Z.C.; Supervision –N.Z.C., Ö.Ö.G.; Materials - N.Z.C.; Data Collection and/or Processing - Ö.Ö.G., T.Ş.; Analysis and/or Interpretation – S.A.G., Ö.Ö.G.; Literature Search- S.A.G.; Writing Manuscript – S.A.G.; Critical Reviews – N.Z.C., Ö.Ö.G.

Conflict of Interest

The authors have no conflicts of interest to declare.

Financial Disclosure

The authors declared that this study has received no financial support.


We thank to Jeremy Jones for revising the English language of the paper and thank to Canan Baydemir for her help with statistical analyses.