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.
Full Pubblication
The survey was supported by:
- European Breast Cancer Research Association of Surgical Trialists (Eubreast)
- European Society of Mastology (EUSOMA)
- Associazione Nazionale Italiana Senologi Chirurghi (ANISC)
- British Association of Breast Surgeons (ABS)
- Oncoplastic Breast Consortium (OPBC)
- Association for Gynecological Oncology / Arbeitsgemeinschaft Gynaekolocische Onkologie (AGO)
- Scuola Italiana di Senologia
- Collegio dei Senologi Italiani
- Società Svizzera di Senologia/Schweizerische Gesellschaft fuer Senologie/ Societè suisse de Senologie
- Polish Society of Surgical Oncology
- Central Eastern European Breast Cancer Surgical Consortium (CEEBCSC)
- German Cancer Association / Deutsches Krebsgesellschaft
- Hellenic Breast Surgical Society
- Russian Association of Oncological Mammology
- Senaturk
