Changes in breast cancer management during the Corona Virus Disease 19 pandemic

Gasparri, Maria Luisa; Gentilini, Oreste Davide; Lueftner, Diana; Kuehn, Thorsten; Kaidar-Person, Orit; Poortmans, Philip

doi:10.1016/j.breast.2020.05.006

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Journal article

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, Maria Luisa Faculty of Biomedical Sciences, Università della Svizzera italiana, Switzerland - Centro di Senologia Della Svizzera Italiana (CSSI), Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland
Gentilini, Oreste Davide Breast Surgery Unit, San Raffaele University Hospital, Milan, Italy
Lueftner, Diana Department of Hematology, Oncology and Tumour Immunology Humboldt-University Berlin, Charité University Medicine, Berlin, Germany
Kuehn, Thorsten Interdisciplinary Breast Center, Department of Gynecology and Obstetrics, Klinikum Esslingen, Germany
Kaidar-Person, Orit Breast Radiation Unit, Oncology Institute, Sheba Hospital Tel Hashomer, Ramat Gan, Israel
Poortmans, Philip Department of Radiation Oncology, Iridium Kankernetwerk, Wilrijk-Antwerp, Belgium - Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk-Antwerp, Belgium

29.05.2020

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The breast. - 2020, vol. 52, p. 110-115

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.

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