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. 2020 Aug:52:110-115.
doi: 10.1016/j.breast.2020.05.006. Epub 2020 May 29.

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)

Maria Luisa Gasparri  1 , Oreste Davide Gentilini  2 , Diana Lueftner  3 , Thorsten Kuehn  4 , Orit Kaidar-Person  5 , Philip Poortmans  6
Affiliations

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)

Maria Luisa Gasparri et al. Breast. 2020 Aug.

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.

Keywords: Breast cancer; Breast surgery; COVID-19; Chemotherapy; Radiation therapy.

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Conflict of interest statement

Declaration of competing interest The authors declare no conflict of interest related to the publication.

Figures

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Fig. 1
Specialties of the responders.
Fig. 2
Fig. 2
Changes in radiation therapy schedules.
See this image and copyright information in PMC

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