Table 2.
Summary of the simulated scenarios
| Scenario | Name | Description | Screening | Diagnosis | Treatment use | Base value (range for sensitivity analysis) |
|---|---|---|---|---|---|---|
| Scenario 1 | No COVID-19 impact | Pandemic does not lead to any changes in breast cancer control | Normal | Normal | Normal | — |
| Scenario 2 | Reduced screening | 50% of women scheduled to undergo exams miss their screening mammography | Reduced | Normal | Normal | 50% (25%-75%) |
| Scenario 2a | Delayed screening | Catch-up screening exam in 6 mo and push all future screening exams by 6 mo | Reduced | Normal | Normal | — |
| Scenario 2b | Skipped screening | Never catches up missed mammography exam | Reduced | Normal | Normal | — |
| Scenario 2c | Hybrid delayed and skipped screening | 50% of women who missed their exams follow scenario 2a and 50% follows scenario 2b | Reduced | Normal | Normal | — |
| Scenario 3 | Delayed diagnosis of symptomatic cases | 25% of women who would normally be detected via symptoms delay diagnosis for 6 mo | Normal | Delayed | Normal | 25% (15%-40%) |
| Scenario 4 | Reduced chemotherapy treatment | Women with ER+/HER2− and stages I and II (node negative) receive reduced chemotherapy at 25% for <70 y and 50% for >70 y but no reduction in use of endocrine therapy | Normal | Normal | Reduced | 25% for ages <70 y; 50% for ages >70 y (12.5%-50% for ages <70 y and 25%-75% for ages >70 y) |
| Scenario 5 | Reduced screening and delayed diagnosis | — | Reduced | Delayed | Normal | — |
| Scenario 5a | Delayed screening and delayed diagnosis | Scenario 2a and scenario 3 combined | Reduced | Delayed | Normal | — |
| Scenario 5b | Skipped screening and delayed diagnosis | Scenario 2b and scenario 3 combined | Reduced | Delayed | Normal | — |
| Scenario 5c | Hybrid delayed/skipped screening and delayed diagnosis | Scenario 2c and scenario 3 combined | Reduced | Delayed | Normal | — |
| Scenario 6 | Reduced screening and delayed diagnosis and reduced chemotherapy treatment | — | Reduced | Delayed | Reduced | — |
| Scenario 6a | Delayed screening and delayed diagnosis and reduced chemotherapy treatment | Scenario 5a and scenario 4 combined | Reduced | Delayed | Reduced | — |
| Scenario 6b | Skipped screening and delayed diagnosis and reduced chemotherapy treatment | Scenario 5b and scenario 4 combined | Reduced | Delayed | Reduced | — |
| Scenario 6c | Hybrid delayed and skipped screening and delayed diagnosis and reduced chemotherapy treatment | Scenario 5c and scenario 4 combined | Reduced | Delayed | Reduced | — |