COVID-19 and breast cancer at a Regional Breast Centre: our flexible approach during the pandemic

Abstract

Purpose In British Columbia (BC), there have been 2790 confirmed COVID-19 cases as of June 20, 2020. The aim of this project is to capture the effect of COVID-19 on the volume of surgery and adaptations to the surgical care of patients at a breast centre in BC. Methods All proven or suspected breast cancer cases treated with surgery between March 16, 2019 and April 30, 2019 and March 16, 2020 and April 30, 2020 through the Providence Breast Centre were included in this review. The date ranges in 2020 mark the early COVID-19 pandemic period in BC and the large shift in operating room access during this time. Results In 2019, 99 patients underwent surgery for proven breast cancer and 30 patients for suspected breast cancer. In 2020, 162 patients underwent surgery for breast cancer and 34 for suspected breast cancer. Wait times from core biopsy to surgery and surgery to oncology consultation were improved in 2020 with a reduction of core biopsy to surgery time from 58 to 28 days for patients seen during the pandemic. There was an increased use of regional anesthesia and same day discharge compared to 2019 with increases in regional anesthesia (41%–89%) and same day discharge (64%–86%) after adaptations to the pandemic were implemented. Conclusions Changes such as improved access to telemedicine, timing for cancer surgeries, and safer anesthetic techniques in response to the pandemic will change breast cancer surgical care beyond the pandemic era. Centralization and team-based care is the way forward.

Breast Reconstruction during the COVID-19 Pandemic: A Systematic Review

“…Nearly all studies offered guidance on how to perform breast reconstruction during the pandemic; however, only 10 studies discussed the development of specific protocols. 14 , 16 , 18 , 20 , 24 , 26 , 27 , 30 , 34 , 35 …”

“…These protocols involved assessment of patient variables such as age, breast cancer characteristics, need for adjuvant therapy, and other comorbidities. 16 , 18 , 24 , 27 , 30 , 34 …”

The Utilization and Benefits of Telehealth Services by Health Care Professionals Managing Breast Cancer Patients During the COVID-19 Pandemic

“…The authors reported that 196 patients in 2020 compared with 129 patients in 2019 successfully underwent BCa surgery and noted significant adaptations that were implemented in response to the COVID-19 pandemic. They are of the opinion that increased access to telemedicine and better anesthetic techniques will significantly improve overall BCa surgical care during and beyond the COVID-19 pandemic [53]. Also, in a recent study Fregatti et al implemented a patient-tailored screening program that sought to prevent COVID-19 infection among health care workers and BCa patients undergoing surgery.…”

Anestesia regional como alternativa para procedimentos médicos na pandemia da COVID-19

“…Por esta razão, pacientes com câncer de mama e demais necessitam de um tratamento que equilibre o risco de progressão tumoral e de contaminação do coronavírus (Sorbo et al, 2020). Para isso, as adaptações perioperatórias incluíram a preferência por a AR (Cadili et al, 2021) para cirurgias emergenciais que apresentam alto risco de vida, classificadas em procedimentos de prioridade cirúrgica A e B (B1) (Holmes, 2020). Cadili et al (2020) avaliou o efeito da COVID-19 na quantidade e necessidade de adaptações a cirurgias de pacientes com câncer de mama na Columbia Britânica entre março a abril de 2019 e no mesmo período em 2020.…”

“…Isso implicou em uma diferença estatisticamente significante nas altas no mesmo dia da cirurgia, sendo de 68% em 2019 e 93% em 2020 (p =0,00001) e maior qualidade das cirurgias. Os autores concluem que a pandemia mudou o tratamento cirúrgico do câncer de mama para além da era pandêmica com a adoção de técnicas anestésicas mais seguras para os pacientes e profissionais da saúde (Cadili et al, 2021).…”