Breast Cancer Management Guidelines During COVID-19 Pandemic

Abstract

The coronavirus disease (COVID-19) pandemic in 2020 has brought about complex challenges in healthcare delivery. With the new rules of lockdown and social distancing and with resources diverted to the management of COVID-19, there are difficulties in continuing usual cancer care. Patients are at risk of contracting COVID-19 with a high chance of patient to healthcare transmission and vice versa. Hospital visits, investigations and all modalities of treatment have potential complications that put patients at risk, some more than others. In this situation, there is a need to change our approach in the management of breast cancer to deliver it safely. We present modified guidelines based on the available consensus statements and evidence.

Triple-Negative Breast Cancer and the COVID-19 Pandemic: Clinical Management Perspectives and Potential Consequences of Infection

“…To minimize possible exposure to the virus, it has been suggested that patients receive chemotherapy in wide intervals. For example, weekly paclitaxel administration is preferred over thrice-weekly docetaxel [ 33 ]. Outpatient administration of chemotherapy has also been raised as a potential solution to reduce hospital visits.…”

“…The standard of care for TNBCs already includes neoadjuvant chemotherapy to which patients respond well, potentially facilitating effective disease management during surgery deferral [ 37 ]. In addition, a study reported that surgery deferral for up to 6–8 weeks following chemotherapy did not impact survival outcomes of breast cancer patients [ 33 , 38 ], supporting the initial use of neoadjuvant chemotherapies among TNBC patients. Depending on patient and institutional factors, however, neoadjuvant therapy may not need to precede surgery.…”

“…Following neoadjuvant or adjuvant chemotherapy and surgery, stage I to III TNBC patients should be referred for radiation oncology according to standard treatment guidelines [ 10 , 45 ]. Patients who have completed neoadjuvant therapy who lack therapeutic targets (i.e., TNBC) are high priority for preoperative radiation therapy [ 33 ]. Despite the COVID-19 pandemic, delays in radiation are not advised due to the risk of recurrence [ 10 , 46 ].…”

Perfil epidemiológico das mortes por câncer de mama e covid-19

“…Atualmente, o conhecimento do perfil epidemiológico e do tratamento da doença COVID-19 é alvo de muitos estudos, porém, poucos estudos foram encontrados na literatura que relacionam esta doença com o câncer de mama, a maioria discute manejo da prática (Luther & Agrawal, 2020) e guidelines (Manoj, et al ,2020). Diante desta situação, e do desconhecimento dos efeitos da COVID-19 em pacientes oncológicos, no que diz respeito tanto a sobrevida como a mortalidade e a falta de literatura científica com essa temática, este estudo tem como objetivo analisar a mortalidade por câncer de mama associada a COVID-19 em mulheres brasileiras.…”

Increased number of prostate cancer patients selecting high dose-rate interstitial brachytherapy during the COVID-19 pandemic

“…Subsequently, the World Health Organization has declared the COVID-19 outbreak a global pandemic on March 12 th 2020 and many large cities around the world experienced lock-down. Several organizations or radiotherapy societies published guidelines or suggested solutions for cancer patient’s management under the global COVID-19 pandemic [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] .…”