Adaptations of Breast Imaging Centers to the COVID-19 Pandemic: A Survey of California and Texas

James S Chalfant; Ethan O Cohen; Jessica W T Leung; Sarah M Pittman; Pranay D Kothari; John R Downey; Rita E Sohlich; Alice Chong; Lars J Grimm; Anne C Hoyt; Haydee Ojeda-Fournier; Bonnie N Joe; Long Trinh; Eric L Rosen; Stephen A Feig; Shadi Aminololama-Shakeri; Debra M Ikeda

doi:10.1093/jbi/wbab020

Adaptations of Breast Imaging Centers to the COVID-19 Pandemic: A Survey of California and Texas

J Breast Imaging. 2021 May 21;3(3):343-353. doi: 10.1093/jbi/wbab020.

Authors

James S Chalfant¹, Ethan O Cohen², Jessica W T Leung², Sarah M Pittman³, Pranay D Kothari³, John R Downey⁴, Rita E Sohlich⁵, Alice Chong⁶, Lars J Grimm⁷, Anne C Hoyt¹, Haydee Ojeda-Fournier⁶, Bonnie N Joe⁸, Long Trinh⁹, Eric L Rosen³, Stephen A Feig¹⁰, Shadi Aminololama-Shakeri¹¹, Debra M Ikeda³

Affiliations

¹ David Geffen School of Medicine at University of California, Los Angeles, Department of Radiological Sciences, Santa Monica, CA, USA.
² The University of Texas MD Anderson Cancer Center, Department of Diagnostic Radiology, Houston, TX, USA.
³ Stanford University School of Medicine, Department of Radiology, Stanford, CA, USA.
⁴ Kaiser Permanente, Department of Radiology, Walnut Creek, CA, USA.
⁵ Sutter Health, Palo Alto Medical Foundation, Department of Radiology, Palo Alto, CA, USA.
⁶ University of California, San Diego, Department of Radiology, La Jolla, CA, USA.
⁷ Duke University Medical Center, Department of Radiology, Durham, NC, USA.
⁸ University of California, San Francisco, Department of Radiology and Biomedical Imaging, San Francisco, CA, USA.
⁹ Santa Clara Valley Medical Center, Department of Radiology, San Jose, CA, USA.
¹⁰ University of California, Irvine Medical Center, Department of Radiological Sciences, Orange, CA, USA.
¹¹ University of California, Davis, Department of Radiology, Sacramento, CA, USA.

Abstract

Objective: To determine the early impact of the COVID-19 pandemic on breast imaging centers in California and Texas and compare regional differences.

Methods: An 11-item survey was emailed to American College of Radiology accredited breast imaging facilities in California and Texas in August 2020. A question subset addressed March-April government restrictions on elective services ("during the shutdown" and "after reopening"). Comparisons were made between states with chi-square and Fisher's tests, and timeframes with McNemar's and paired t-tests.

Results: There were 54 respondents (54/240, 23%, 26 California, 28 Texas). Imaging volumes fell during the shutdown and remained below pre-pandemic levels after reopening, with reduction in screening greatest (ultrasound 12% of baseline, mammography 13%, MRI 23%), followed by diagnostic MRI (43%), procedures (44%), and diagnostics (45%). California reported higher volumes during the shutdown (procedures, MRI) and after reopening (diagnostics, procedures, MRI) versus Texas (P = 0.001-0.02). Most screened patients (52/54, 96% symptoms and 42/54, 78% temperatures), and 100% (53/53) modified check-in and check-out. Reading rooms or physician work were altered for social distancing (31/54, 57%). Physician mask (45/48, 94%), gown (15/48, 31%), eyewear (22/48, 46%), and face shield (22/48, 46%) use during procedures increased after reopening versus pre-pandemic (P < 0.001-0.03). Physician (47/54, 87%) and staff (45/53, 85%) financial impacts were common, but none reported terminations.

Conclusion: Breast imaging volumes during the early pandemic fell more severely in Texas than in California. Safety measures and financial impacts on physicians and staff were similar in both states.

Keywords: COVID-19; breast imaging; financial impact; safety measures.