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This study examines the effect of COVID-19 pandemic and associated lockdownson access to crucial diagnostic procedures for breast cancer patients,including screenings and treatments. To quantify the impact of the lockdowns onpatient outcomes and cost, the study employs a mathematical model of breastcancer progression. The model includes ten different states that representvarious stages of health and disease, along with the four different stages ofcancer that can be diagnosed or undiagnosed. The study employs a naturalhistory stochastic model to simulate the progression of breast cancer inpatients. The model includes transition probabilities between states, estimatedusing both literature and empirical data. The study utilized a Markov ChainMonte Carlo simulation to model the natural history of each simulated patientover a seven-year period from 2019 to 2025. The simulation was repeated 100times to estimate the variance in outcome variables. The study found that theCOVID-19 pandemic and associated lockdowns caused a significant increase inbreast cancer costs, with an average rise of 172.5 million PLN (95% CI [82.4,262.6]) and an additional 1005 breast cancer deaths (95% CI [426, 1584]) inPoland during the simulated period. While these results are preliminary, theyhighlight the potential harmful impact of lockdowns on breast cancer treatmentoutcomes and costs.

Estimation of the Impact of COVID-19 Pandemic Lockdowns on Breast Cancer Deaths and Costs in Poland using Markovian Monte Carlo Simulation