Breast Cancer Surgery in the COVID-19 Pandemic: Validation of a Preventive Program for Patients and Health Care Workers

Fregatti, Piero; Gipponi, Marco; Giacchino, Maria; Sparavigna, Marco; Díaz, Raquel; Fioravanti, E.; Cornacchia, Chiara; Conte, Benedetta; Lambertini, Matteo; Zoppoli, Gabriele; Murelli, Federica; Toni, Maria Luisa; Calabrò, Maria Teresa; Orsino, Lina; Friedman, Daniele

doi:10.21873/invivo.12302

Cited by 3 publications

(10 citation statements)

References 6 publications

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“… 114 Fregatti et al in Italy reported that COVID-19 posed an increased risk of mortality in breast cancer patients, with all 3 breast cancer patients (out of 207 studied) hospitalized in their study due to COVID-19 infections subsequently dying. 102 However, Kathuria-Prakash et al in the USA in their study reported that patients who received endocrine therapy were less likely to suffer from adverse conditions with COVID-19 infections. Overall, 30.3% of breast cancer patients with COVID-19 infection had to be hospitalized in their study, 8.3% needed intensive care, and 6.1% died.…”

Section: Resultsmentioning

confidence: 96%

“… The protocol was safe and effective for immediate implant-based BR after tumour resection. Fregatti et al, Italy 102 Observational study 9 Mar 2020–9 Jun 2020b 203 (NR) Preventive surgery strategies during COVID-19 A patient-tailored program was followed to avoid hospitalization of COVID-19 symptomatic patients and to prioritize surgical procedures. Breast-conserving surgery was mainly preferred.…”

Section: Resultsmentioning

confidence: 99%

“…Lisa et al also developed guidelines ensuring patient and clinician protection and discharging patients quickly, which was helped by appropriate pain management telemedicine facilities. 102–104 In Singapore, Mok et al included deferring non-urgent surgeries in their guidelines, performing surgery with the shortest anaesthesia and post-operative period. 46 In Spain, Brenes Sánchez et al introduced similar guidelines with surgery deferred where possible, aided by systemic therapy, and, when performed, designed to minimize complications and post-operative stay.…”

Section: Resultsmentioning

confidence: 99%

“… The COVID-19 infection rate and related complications were low in breast cancer patients. High-income countries Fregatti et al, Italy 102 Observational study 9 Mar 2020–9 Jun 2020b 203 (NR) The death rate of breast cancer patients with COVID-19 3 out of 207 breast cancer patients were hospitalized after being infected by COVID-19, all of which died. COVID-19 imposes an increased risk of mortality in breast cancer patients.…”

Section: Resultsmentioning

confidence: 99%

“… The psychological conditions of breast cancer patients should be addressed more during COVID-19. High-income countries Fregatti et al, Italy 102 Observational study 9 Mar 2020–9 Jun 2020 203 (NR) Fear of COVID-19 7.4% of breast cancer patients were more afraid of COVID-19 than their cancer. N/A Vanni et al, Italy 119 Monocentric retrospective study 16 Jan 2020–20 Mar 2020 160 (post-COVID: 59.5 years) Refusal of procedure and surgery Significantly* more refusals during COVID-19 than before.…”

Section: Resultsmentioning

confidence: 99%

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Breast Cancer Management in the Era of Covid-19; Key Issues, Contemporary Strategies, and Future Implications

Prodhan

Islam

Khandker

et al. 2023

BCTT

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During the COVID-19 pandemic, several priority diseases were not getting sufficient attention. Whilst breast cancer is a fatal disease affecting millions worldwide, identification and management of these patients did not initially attract critical attention to minimize the impact of lockdown, post-lockdown, and other measures. Breast cancer patients’ conditions may not remain stable without proper care, worsening their prognosis. Proper care includes the timely instigation of surgery, systemic therapy, and psychological support. This includes low-and middle-income countries where there are already concerns with available personnel and medicines to adequately identify and treat these patients. Consequently, there was a need to summarize the current scenario regarding managing breast cancer care during COVID-19 across all countries, including any guidelines developed. We systematically searched three scientific databases and found 76 eligible articles covering the medical strategies of high-income countries versus LMICs. Typically, diagnostic facilities in hospitals were affected at the beginning of the pandemic following the lockdown and other measures. This resulted in more advanced-stage cancers being detected at initial presentation across countries, negatively impacting patient outcomes. Other than increased telemedicine, instigating neo-adjuvant endocrine therapy more often, reducing non-essential visits, and increasing the application of neo-adjuvant chemotherapy to meet the challenges, encouragingly, there was no other significant difference among patients in high-income versus LMICs. Numerous guidelines regarding patient management evolved during the pandemic to address the challenges posed by lockdowns and other measures, which were subsequently adopted by various high-income countries and LMICs to improve patient care. The psychological impact of COVID-19 and associated lockdown measures, especially during the peak of COVID-19 waves, and the subsequent effect on the patient’s mental health must also be considered in this high-priority group. We will continue to monitor the situation to provide direction in future pandemics.

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Section: Resultsmentioning

confidence: 96%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Breast Cancer Management in the Era of Covid-19; Key Issues, Contemporary Strategies, and Future Implications

Prodhan

Islam

Khandker

et al. 2023

BCTT

View full text Add to dashboard Cite

show abstract

Evaluation of the efficacy and safety of oral N‐acetylcysteine in patients with COVID‐19 receiving the routine antiviral and hydroxychloroquine protocol: A randomized controlled clinical trial

Atefi,

Goodarzi,

Riahi

et al. 2023

Immunity Inflam & Disease

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BackgroundThe current absence of gold‐standard or all‐aspect favorable therapies for COVID‐19 renders a focus on multipotential drugs proposed to prevent or treat this infection or ameliorate its signs and symptoms vitally important. The present well‐designed randomized controlled trial (RCT) sought to evaluate the efficacy and safety of N‐acetylcysteine (NAC) as adjuvant therapy for 60 hospitalized Iranian patients with COVID‐19.MethodsTwo 30‐person diets, comprising 15 single diets of Kaletra (lopinavir/ritonavir) + hydroxychloroquine (HCQ) with/without NAC (600 mg TDS) and atazanavir/ritonavir + HCQ with/without NAC (600 mg TDS), were administered in the study.ResultsAt the end of the study, a further decrease in C‐reactive protein was observed in the NAC group (P = 0.008), and no death occurred in the atazanavir/ritonavir + HCQ + NAC group, showing that the combination of these drugs may reduce mortality. The atazanavir/ritonavir + HCQ and atazanavir/ritonavir + NAC groups exhibited the highest O2 saturation at the end of the study and a significant rise in O2 saturation following intervention commencement, including NAC (P > 0.05). Accordingly, oral or intravenous NAC, if indicated, may enhance O2 saturation, blunt the inflammation trend (by reducing C‐reactive protein), and lower mortality in hospitalized patients with COVID‐19.ConclusionThe NAC could be more effective as prophylactic or adjuvant therapy in stable non‐severe cases of COVID‐19 with a particularly positive role in the augmentation of O2 saturation and faster reduction of the CRP level and inflammation or could be effective for better controlling of COVID‐19 or its therapy‐related side effects.

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Evaluation of the Efficacy and Safety of Oral N-acetylcysteine in Patients With COVID-19 Receiving the Routine Antiviral and Hydroxychloroquine Protocol: A Randomized Controlled Clinical Trial

Atefi,

Goodarzi,

riahi

et al. 2024

Preprint

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The current absence of gold-standard or all-aspect favorable therapies for COVID-19 renders a focus on multipotential drugs proposed to prevent or treat this infection or ameliorate its signs and symptoms vitally important. The present well-designed randomized controlled trial sought to evaluate the efficacy and safety of N-acetylcysteine as adjuvant therapy in hospitalized Iranian patients with COVID-19. Four different diets in 60 patients include; Kaletra (lopinavir/ritonavir) + hydroxychloroquine with/without N-acetylcysteine (600 mg TDS) and atazanavir/ritonavir + hydroxychloroquine with/without N-acetylcysteine (600 mg TDS), were administered in the study. At the end of the study, a further decrease in C-reactive protein was observed in groups with N-acetylcysteine (P =0.008), and no death occurred in the atazanavir/ritonavir + hydroxychloroquine + N-acetylcysteine group, showing that the combination of these drugs may reduce mortality. A significant rise in O2 saturation was observed in atazanavir/ritonavir+hydroxychloroquine+N-acetylcysteine group (P <0.05). Accordingly, oral or intravenous N-acetylcysteine, may enhance O2 saturation, blunt the inflammation trend (by reducing C-reactive protein), and reduce mortality in hospitalized patients with COVID-19. The N-acetylcysteine could be more effective as prophylactic or adjuvant therapy in stable and non-severe cases of COVID-19 with a particularly positive role in the augmentation of O2 saturation and faster reduction of the CRP level and inflammation.

show abstract

Breast Cancer Surgery in the COVID-19 Pandemic: Validation of a Preventive Program for Patients and Health Care Workers

Cited by 3 publications

References 6 publications

Breast Cancer Management in the Era of Covid-19; Key Issues, Contemporary Strategies, and Future Implications

Breast Cancer Management in the Era of Covid-19; Key Issues, Contemporary Strategies, and Future Implications

Evaluation of the efficacy and safety of oral N‐acetylcysteine in patients with COVID‐19 receiving the routine antiviral and hydroxychloroquine protocol: A randomized controlled clinical trial

Evaluation of the Efficacy and Safety of Oral N-acetylcysteine in Patients With COVID-19 Receiving the Routine Antiviral and Hydroxychloroquine Protocol: A Randomized Controlled Clinical Trial

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