Breast Cancer Management During the COVID-19 Pandemic: The Senologic International Society Survey

Abstract

Objective: In early 2020, the spread of coronavirus disease-2019 led the World Health Organization to declare this disease a pandemic. Initial epidemiological data showed that patients with cancer were at high risk of developing severe forms of COVID-19. National scientific societies published recommendations modifying the patients' breast cancer (BC) management to preserve, in theory, quality oncologic care, avoiding the increased risk of contamination. The Senology International Society (SIS) decided to take an inventory of the actions taken worldwide. This study investigates COVID-19-related changes concerning BC management and analyzes the will to maintain them after the pandemic, evaluating their oncological safety consequences.Materials and Methods: SIS network members participated in an online survey using a questionnaire (Microsoft® Forms) from June 15 th to July 31 st , 2020.Results: Forty-five responses from 24 countries showed that screening programs had been suspended (68%); magnetic resonance imagines were postponed (73%); telemedicine was preferred when possible (71%). Surgeries were postponed: reconstructive (77%), for benign diseases (84%), and in patients with significant comorbidities (66%). Chemotherapy and radiotherapy protocols had been adapted in 28% of patients in both. Exception for telemedicine (34%), these changes in practice should not be continued. Conclusion:The SIS survey showed significant changes in BC's diagnosis and treatment during the first wave of the COVID-19 pandemic, but most of these changes should not be maintained. Indeed, women have fewer severe forms of COVID-19 and are less likely to die than men. The risk of dying from COVID-19 is more related to the presence of comorbidities and age than to BC. Stopping screening and delaying treatment leads to more advanced stages of BC. Only women aged over 65 with BC under treatment and comorbidities require adaptation of their cancer management.

A New Modality for Breast Cancer Diagnosis During the COVID-19 Pandemic: A Case Report

“…People at risk of serious SARS-CoV-2 infections who require further examination or even hospitalization also present an increased risk for BC. Both diseases have common risk factors, such as advanced age, obesity, and type 2 diabetes (3,11,12). Chest scans performed as part of the diagnosis of COVID-19 infection are generally not accompanied by administration of iodized contrast, except when a pulmonary embolism is suspected, particularly in severe forms (13).…”

“…The objective was twofold, not to result in a loss of chance from an oncological perspective, while protecting from a possible COVID-19 infection. The suspension of screening was one of these measures (2,3). Computed tomography (CT) scans, frequently performed in patients infected with SARS-CoV-2, have thus become one of the ways of detecting asymptomatic breast abnormalities.…”

Prognostic factors in cancer patients infected with SARS-CoV-2: a Latin American country results

“…Some reports have shown that women with breast cancer have fewer severe forms of COVID-19 and less likely to die. 25,26 Regarding the oncologic treatment, when performing the step-by-step regression, it was detected that receiving treatment increased the odds of death. However, this effect was diluted upon inclusion on the multivariate analysis and variable adjustment.…”

A New Modality for Breast Cancer Diagnosis During the COVID-19 Pandemic. A Case Report

“…People at risk of serious SARS-CoV-2 infections who require further examination or even hospitalization also present an increased risk for BC. Both diseases have common risk factors such as advanced age, obesity, and type 2 diabetes (3,11,12). Chest scans performed as part of the COVID-19 infection check-up are generally not accompanied by administration of iodized contrast except when a pulmonary embolism is suspected, particularly in severe forms (13).…”

“…The objective was twofold, not to result in a loss of chance from an oncological perspective, while protecting from a possible COVID-19 infection. The suspension of screening was one of these measures (2,3). Computed tomography (CT) scans frequently performed in patients infected with SARS-CoV-2 infections have thus become one of the ways of detecting asymptomatic breast abnormalities.…”