by Maria Luisa Gasparri, Oreste Davide Gentilini, Diana
Lueftner, Thorsten Kuehn, Orit Kaidar-Person, Philip Poortmans
The Breast: VOLUME 52, P110-115, AUGUST
01, 2020
Highlights
•Management of breast cancer patients was modified during
the pandemic.
•Waiting time increased during the pandemic in 20% of the
institutions.
•A workload reduction of ≥50% was reported in 1/3 and
relocation of the centres in 13%.
•It is unknown whether these changes will affect outcome of
breast cancer patients.
Abstract
Background
Corona Virus Disease 19 (COVID-19) had a worldwide negative
impact on healthcare systems, which were not used to coping with such pandemic.
Adaptation strategies prioritizing COVID-19 patients included triage of
patients and reduction or re-allocation of other services. The aim of our
survey was to provide a real time international snapshot of modifications of
breast cancer management during the COVID-19 pandemic.
Methods
A survey was developed by a multidisciplinary group on
behalf of European Breast Cancer Research Association of Surgical Trialists and
distributed via breast cancer societies. One reply per breast unit was
requested.
Results
In ten days, 377 breast centres from 41 countries completed
the questionnaire. RT-PCR testing for SARS-CoV-2 prior to treatment was
reported by 44.8% of the institutions. The estimated time interval between
diagnosis and treatment initiation increased for about 20% of institutions.
Indications for primary systemic therapy were modified in 56% (211/377), with upfront
surgery increasing from 39.8% to 50.7% (p < 0.002) and from 33.7%
to 42.2% (p < 0.016) in T1cN0 triple-negative and
ER-negative/HER2-positive cases, respectively. Sixty-seven percent considered
that chemotherapy increases risks for developing COVID-19 complications.
Fifty-one percent of the responders reported modifications in chemotherapy
protocols. Gene-expression profile used to evaluate the need for adjuvant
chemotherapy increased in 18.8%. In luminal-A tumours, a large majority (68%)
recommended endocrine treatment to postpone surgery. Postoperative radiation
therapy was postponed in 20% of the cases.
Conclusions
Breast cancer management was considerably modified during
the COVID-19 pandemic. Our data provide a base to investigate whether these changes
impact oncologic outcomes.
