OBJECTIVES: In the era of the COVID-19 pandemic, we need to emphasize the cancer care disruption and reorganization. Some restrictive measures imposed temporary reorganization of the health-system and few studies evaluated impact of COVID-19 pandemic on cancer patients with highlighting oncologic treatments delay and increased tumor dimensions, advanced N-staging. The aim of our study was to evaluate the effect of COVID-19 pandemic in Romania, comparing the number of patients and the cancer treatment costs in the case of breast cancer in Romania in the last four years (2018-2021).

METHODS: We used anonymized patient data reported by hospitals from Dolj County, Romania, at the Health Insurance House of Dolj, for ICD-10 code of C50, from January 1^st, 2018, to December 31st, 2021. We assessed costs burden in breast cancer treatment costs among non-COVID-19 and COVID-19 pandemic.

RESULTS: A total of 711 female patients (average age=60.38) were treated in 2018 and the total direct costs of their treatment was 62.3 million EUR). For the next years, the number of identified female patients and their treatment costs were: 2019 (708 patients-average age=60.11, 102.7 million EUR), 2020 (687 patients-average age=60.49, 110 million EUR), 2021 (681 patients-average age=60.87, 94.1 million EUR). The distribution for male patients was: 2018 (12 patients-average age=69.37, 0.19 million EUR), 2019 (8 patients-average age=63.54, 0.24 million EUR), 2020 (11 patients-average age=62.25, 0.45 million EUR), 2021 (12 patients-average age=63.41, 0.8 million EUR).

CONCLUSIONS: In Dolj county (with a population of 618,355), Romania, the cancer patients were treated for their neoplasm during SARS-CoV-2 pandemic without observing a decreasing in the breast cancer patients’ number. According to our data, even if the number of patients remained the same, the cancer treatment costs have risen exponentially from 2018 to 2021. Additional analysis is planned to assess further insight into treatment patterns of patients.