Adjuvant Systemic Anti-cancer Therapy in Early Breast Cancer During the COVID-19 Pandemic: Differences between Clinicians and Patients in Perception of Treatment Risks and Benefits

Abstract

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Impact of Strategies for Mitigating Delays and Disruptions in Cancer Care Due to COVID-19: Systematic Review

“…We identified two case series, 49 , 51 three cross-sectional studies, 45 - 47 and four analytical cross-sectional studies. 43 , 44 , 48 , 50 …”

“…Sample sizes ranged from 15 51 to 585. 50 The strategies target health care for nonspecified types of cancers, 44 , 48 - 50 breast cancer, 47 - 51 head and neck cancer, 43 , 45 and lung cancer. 46 …”

“…One study found that shared decision making in adjuvant therapies lowered the frequency of treatment interruption among intermediate- or high-risk patients. 47 These studies have provided cross-sectional data that limited the ability to interpret, attribute, or suggest any generalizable negative or positive impact on overall cancer outcomes. A systematic approach to decision making and the resultant impact of health service study was reported by one study from Iran.…”

Challenges of cancer immunotherapy and chemotherapy during the COVID-19 pandemic

“…This is due to the reduction of proinflammatory warning signs combined with overexpression of immunosuppressive cytokines and immunosuppressive activity by leukocytes. 5,[10][11][12][13] For example, patients who had undergone surgery or chemotherapy in the preceding month demonstrated a significantly higher (75%) risk of clinically serious complications versus those who had not undergone surgery or chemotherapy (43%). 14 Recent studies suggest that not all patients with cancer are at the same high risk of severe COVID-19 infection.…”

Factors associated with adjuvant systemic anti‐cancer treatment discontinuation for early breast cancer during the COVID‐19 pandemic

“…Nonetheless, both clinicians and patients are still faced with difficult decisions regarding whether to alter SACT based on the risk posed by SARS‐CoV‐2 infection and that of cancer relapse and progression. We have recently reported significant differences in the perception of treatment risks and benefits between clinicians and patients with early breast cancer, with a significant proportion of patients reluctant to accept a therapeutic pause as they feared cancer relapse more than the risks posed by SAR‐CoV‐2 infection (Gatfield et al, 2020 ). In this paper, we analysed the decisions made by patients with early breast cancer regarding their adjuvant SACT during the Covid‐19 pandemic and explore the clinical factors associated with their decisions to discontinue treatment.…”