Breast care physicians encourage a return to regular pre-pandemic screenings and cancer awareness

In the early months of the pandemic, a combination of uncertainty, fear, anxiety and an abundance of caution resulted in a delay of care for Sonoma County breast cancer patients.

Routine screening exams were put off and surgeries for local breast cancer patients were delayed for a time. Some patients were put on various medications based on their type of cancer while the world came to grips with COVID-19.

Dr. Linda Casey, a radiologist with Sutter Pacific Medical Foundation, said today she and other medical professionals are busy trying to care for all those patients whose routine care and treatment was eclipsed by a historic global pandemic.

“We’re doing overcapacity, over our pre-pandemic levels -- we’re still playing catch-up for sure,” said Casey, who is chief of breast imaging at Sutter Health’s Airway Drive Imaging center in Santa Rosa.

Casey said that before COVID-19, her medical group detected 50% of all breast cancers through screenings. She said more recently, about six of eight new breast cancer diagnoses were detected through a screening exam.

She said now that patients are coming back, a lot of the cancers that she’s been diagnosing and screening likely would have been detected in 2020. Casey said that delay usually “doesn’t make that much difference, unless it’s an aggressive cancer.”

Twenty months into the pandemic, Casey and other local specialists are eager to get their patients back to their normal breast care routines, letting them know that appropriate precautions and an aggressive local vaccination campaign have made it safe to visit medical facilities.

At Providence Medical Group, breast care physicians are back to their normal volume of patients, but they should be seeing more people than they did two years ago.

“The concern there is obviously we knew we had a tremendous drop in patients that were in before, so we should really be seeing all those extra patients, as well,” said Dr. Brittany Dashevsky, a diagnostic radiologist for Providence Medical Group.

When the pandemic first hit, and medical facilities across the country began shutting their doors for all but emergency and essential services, Dashevsky temporarily ended screening exams at the medical group’s breast surgery and primary care oncology offices on Sotoyome Street in downtown Santa Rosa. Patients with new symptoms, however, were still being treated but routine screenings were not conducted until the end of April and beginning of May.

After that, screenings were resumed at half capacity, Dashevsky said. Last year, from February to August, the imaging center saw a 45% decline in volume of screening exams due, in part, to new safety protocols.

But Dashevsky said patient hesitancy also contributed to the decline. When screenings were canceled back in March 2020, staff tried to reschedule appointments for six months later, but some still resisted coming in. Dashevsky said her group is fully compliant with vaccination and testing guidelines from the California Department of Public Health.

“As the pandemic has stretched now for a year and a half, it becomes more concerning,” she said, referring to patient reluctance or hesitancy in resuming care and screenings. “The best tool in fighting breast cancer is really early detection and that’s something we really emphasize to our patients.”

Dashevsky said patients with symptoms should “really come in as soon as they can so that we can address underlying issues or things that are going on.”

Dr. Alexis Alexandridis, a surgeon and medical director of wound care medicine at Sonoma Valley Hospital, said that during the initial shelter in place last year, she had a few patients whose surgeries were delayed. These patients, she said, underwent medical therapy for their cancers until the operating facility for non-emergent cases was reopened, with new pre-operative COVID-19 testing protocols.

“Their delays were not significant and I don’t think it will impact these particular patients’ prognoses in the long term,” Alexandrisis, a member of the Meritage Medical Network, said.

She said that since summer 2020 she’s not seen many delays in breast cancer care for Sonoma Valley Hospital patients once they’ve come to see her.

“On the colorectal cancer screening side, I had many conversations with folks choosing to hold off on screening colonoscopy ‘until the pandemic is over’ or some other arbitrary time point,” Alexandrisis said.

Alexandrisis said that to really assess whether COVID-19 has caused an impact on cancer detection rates or stages at the time of diagnosis, “we will have to look back at the trends on a larger scale.”

The Sonoma Valley Hospital medical director said high vaccination rates in south east Sonoma County has helped keep us from becoming completely overrun with COVID-19.

“Compared to reports of cancer care delays from some of my colleagues practicing in other parts of the country, we have been doing relatively well,” she said.

Dr. Lisa Tito, a breast surgeon with Providence Medical Group in Santa Rosa, also said the vaccination campaign has done wonders to relieve patients, particularly older patients, of some of their anxiety. For Tito, a steady volume of surgeries didn’t resume until the beginning of this year.

A lot of people were afraid of “coming to the hospital,” despite the fact that Providence’s breast care offices are in a separate building. The vaccine changed that.

“My catching up on my backlog really started once that older population got their vaccinations,” Tito said. “Then they started calling in and saying, ‘I’m ready.’”

Tito said the COVID-19 vaccine has led to a greater degree of “normalcy,” and she encouraged the county’s remaining 14% of eligible residents to get inoculated.

According to county data, local residents who are unvaccinated are seven times more likely to be hospitalized for COVID-19 than those who are fully vaccinated. During the peak of the delta surge this summer, the unvaccinated were 14 times more likely to end up in the hospital, compared to vaccinated residents.

“The unvaccinated population is slowing our return to economic normalcy, social normalcy, life normalcy,” Tito said.

You can reach Staff Writer Martin Espinoza at 707-521-5213 or martin.espinoza@pressdemocrat.com. On Twitter @pressreno.