Introduction: An important consequence of the COVID-19 pandemic on health services has been a reduction in cancer diagnoses. The number of new patient referrals and symptomatic breast cancer diagnoses substantially decreased in our unit in April 2020 with the start of lockdown. The aim of this study was to establish if and why patients delayed seeking review for their symptoms.
Methods: Consecutive new patients attending the symptomatic breast clinic between 29/05/2020 and 10/06/2020 were asked to complete a survey before their appointments.
Results: Seventy patients completed the survey. 40.0% had delayed seeking medical advice for their breast symptoms for an average of 55 days (SD = 41.6). The most common reason given for delaying was to 'avoid burdening the NHS' (46.4%). A minority of patients (7.4%) reported problems accessing primary care. 42.6% of patients felt they were not given adequate information about hospital COVID-19 guidelines and procedures.
Conclusion: With few patients reporting problems accessing GP services and no change of referral guidance sent to GPs, it appears that the reduction in secondary care referrals was due to patients not presenting to primary care in the first place. In the period immediately after lockdown, 40% of patients attending the breast clinic admitted they had postponed seeking medical advice during the COVID-19 pandemic. Most of these patients did so due to fear of overburdening the NHS rather than of COVID-19 itself. Efforts need to be made to inform patients that it is safe and appropriate to seek advice for breast symptoms.