Changes in breast cancer management during the Corona Virus Disease 19 pandemic: An international survey of the European Breast Cancer Research Association of Surgical Trialists (EUBREAST).
- Gasparri ML Department of Gynecology and Obstetrics, University of the Italian Switzerland (USI), Ospedale Regionale di Lugano, Lugano, Switzerland; Centro di Senologia Della Svizzera Italiana (CSSI), Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland. Electronic address: marialuisa.gasparri@eoc.ch.
- Gentilini OD Breast Surgery Unit, San Raffaele University Hospital, Milan, Italy.
- Lueftner D Department of Hematology, Oncology and Tumour Immunology Humboldt-University Berlin, Charité University Medicine, Berlin, Germany.
- Kuehn T Interdisciplinary Breast Center, Department of Gynecology and Obstetrics, Klinikum Esslingen, Germany.
- Kaidar-Person O Breast Radiation Unit, Oncology Institute, Sheba Hospital Tel Hashomer, Ramat Gan, Israel.
- Poortmans P Department of Radiation Oncology, Iridium Kankernetwerk, Wilrijk-Antwerp, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk-Antwerp, Belgium.
- 2020-06-06
Published in:
- Breast (Edinburgh, Scotland). - 2020
Breast cancer
Breast surgery
COVID-19
Chemotherapy
Radiation therapy
Antineoplastic Agents
Antineoplastic Agents, Hormonal
Antineoplastic Agents, Immunological
Betacoronavirus
Breast Neoplasms
Chemotherapy, Adjuvant
Clinical Laboratory Techniques
Coronavirus Infections
Delivery of Health Care
Disease Management
Europe
Gene Expression Profiling
Humans
Mass Screening
Mastectomy
Pandemics
Pneumonia, Viral
Radiotherapy
Radiotherapy, Adjuvant
Surveys and Questionnaires
Time-to-Treatment
Workload
English
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.
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.
- Language
-
- English
- Open access status
- gold
- Identifiers
-
- DOI 10.1016/j.breast.2020.05.006
- PMID 32502796
- Persistent URL
- https://sonar.ch/global/documents/279113
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