How to maintain elective treatment of breast cancer during the COVID‐19 pandemic—A cancer center experience

Leite, Fernanda; Curi, Carla; Sanches, Solange Moraes; Curado, María Paula; Fernandes, Gisele Aparecida; Moraes, Samira; Sonagli, Marina; Bussolotti, Raquel Marcondes; Andrade, Victor Piana de; Silva, Ivan L A F E; Makdissi, Fabiana Baroni Alves

doi:10.1002/jso.26233

Cited by 7 publications

(24 citation statements)

References 4 publications

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“…Since the beginning of the COVID‐19 pandemic in Brazil, the AC Camargo Cancer Center implemented protective measures for patients, caregivers, and health professionals, while simultaneously maintaining the best possible cancer treatment 3 . Before the implementation of telemedicine appointments, all patients were contacted preceding their in‐person appointments so as to receive specific instructions and triage of SARS‐CoV‐2 signs and symptoms 3 …”

Section: Discussionmentioning

confidence: 99%

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The use of telemedicine to maintain breast cancer follow‐up and surveillance during the COVID‐19 pandemic

Sonagli

Neto

Leite

et al. 2020

Journal of Surgical Oncology

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As a result from restricted economic activities and social distancing due to the coronavirus disease‐2019 (COVID‐19) pandemic, we observed a 49.4% decrease in outpatient appointments at our Institution. to minimize this impact on screening and oncological follow‐up of breast cancer patients, telemedicine appointments were established. The authors demonstrate how a cancer center in the largest city in Brazil has managed outpatient appointments during the COVID‐19 pandemic. This is a retrospective study of patients who had their appointments through telemedicine at the AC Camargo Cancer Center between June 2020 and October 2020, during the COVID‐19 pandemic. Of the 77 patients who had telemedicine appointments, 36 (46.8%) accounted for breast cancer follow‐up, 20 (26%) for breast cancer screening, 10 (13%) for benign breast disease evaluation, 7 (9%) for a second opinion, and 4 (5.2%) for general orientations. Routine surveillance/follow‐up exams were requested for 45 (58.4%) patients and breast image exams and a request to return for a personal appointment for 30 (39%) patients. Two (2.6%) patients were requested to schedule a personal appointment immediately for a physical exam. In conclusion, telemedicine may be a feasible alternative to reduce personal outpatient appointments for cancer follow‐up and breast cancer screening during the COVID‐19 pandemic.

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Section: Discussionmentioning

confidence: 99%

“…Nonetheless, social distancing and fear of transmission have affected diagnosis and treatment of many cancer patients during the pandemic. A recent study showed a 49.4% decrease in patient appointments and a 13.17% decrease in breast surgeries between the months of March and May 2020, at the AC Camargo Cancer Center 3 …”

Section: Introductionmentioning

confidence: 98%

The use of telemedicine to maintain breast cancer follow‐up and surveillance during the COVID‐19 pandemic

Sonagli

Neto

Leite

et al. 2020

Journal of Surgical Oncology

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“…Having been in operation for over 60 years, it is the primary oncologic reference in South America and attends an average of 8,000 new cases of cancer annually [26] . An ACCCC crisis committee was created on March 13, 2020 to implement a safe flow for coping with COVID-19, with the objective of treating patients and ensuring the safety of the professionals involved [27] .…”

Section: Introductionmentioning

confidence: 99%

Differences in mortality of cancer patients with COVID-19 in a Brazilian cancer center

Fernandes

Feriani

Silva

et al. 2021

Seminars in Oncology

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Introduction To analyze COVID-19 mortality in cancer patients and associated factors such as age, sex, type of insurance, situation at COVID-19 diagnosis, and cancer histology during the pandemic at a cancer center in Brazil. Methods Cross-sectional study carried out from April 02, 2020 to August 31, 2020 at A.C. Camargo Cancer Center (ACCCC), in São Paulo, Brazil. Cases were extracted from the Hospital Cancer Registry. COVID-19 lethality rates by histology were calculated; multiple logistic regression was used to identify factors associated with COVID-19 mortality. The log-rank test was applied to compare the survival curves for each variable. Results Of the 411 patients analyzed, 51 (12.4%) died due to COVID-19. Death occurred at an average age of 63 years. The fatality rate was higher for lung (0.333) and hematological (0.213) cancers and was associated with age over 60 years. The greatest chances of death from COVID-19 were in cases of lung (odds ratio, OR, 4.05, 95% confidence interval, CI 1.33–12.34) and hematological (OR 2.17, 95% CI 0.96–4.90) cancers, and in patients currently undergoing cancer treatment (OR 2.77, 95% CI 1.25–6.13). There were no statistical differences in survival by sex, age group, type of insurance, situation at the diagnosis of COVID-19, and histology of cancer for COVID-19. Conclusions Mortality due to COVID-19 in cancer patients is heterogeneous. These findings reinforce the need for individualized strategies for the management of different types of cancer that reduce the risk of death from COVID-19.

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“…Generally, detailed treatment algorithms for breast- or colorectal cancer are individualised to patient needs and actioned by multidisciplinary teams, with shared decision-making by patients [ 18 ]. Biomedical treatment modalities may be classified as operative (surgical) or non-operative (medical) [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

Global elective breast- and colorectal cancer surgery performance backlogs, attributable mortality and implemented health system responses during the COVID-19 pandemic: A scoping review

Haribhai

Bhatia

Shahmanesh

2023

PLOS Glob Public Health

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Globally, 28.4 million non-emergent (‘elective’) surgical procedures have been deferred during the COVID-19 pandemic. This study evaluated the impact of the COVID-19 pandemic on elective breast- or colorectal cancer (CRC) procedure backlogs and attributable mortality, globally. Further, we evaluated the interaction between procedure deferrals and health systems, internationally. Relevant articles from any country, published between December 2019–24 November 2022, were identified through searches of online databases (MEDLINE, EMBASE) and by examining the reference lists of retrieved articles. We organised health system-related findings thematically per the Structures-Processes-Outcomes conceptual model by Donabedian (1966). Of 337 identified articles, we included 50. Eleven (22.0%) were reviews. The majority of included studies originated from high-income countries (n = 38, 76.0%). An ecological, modelling study elucidated that global 12-week procedure cancellation rates ranged from 68.3%–73%; Europe and Central Asia accounted for the majority of cancellations (n = 8,430,348) and sub-Saharan Africa contributed the least (n = 520,459). The percentage reduction in global, institutional elective breast cancer surgery activity ranged from 5.68%–16.5%. For CRC, this ranged from 0%–70.9%. Significant evidence is presented on how insufficient pandemic preparedness necessitated procedure deferrals, internationally. We also outlined ancillary determinants of delayed surgery (e.g., patient-specific factors). The following global health system response themes are presented: Structural changes (i.e., hospital re-organisation), Process-related changes (i.e., adapted healthcare provision) and the utilisation of Outcomes (i.e., SARS-CoV-2 infection incidence among patients or healthcare personnel, postoperative pulmonary complication incidence, hospital readmission, length of hospital stay and tumour staging) as indicators of health system response efficacy. Evidence on procedure backlogs and attributable mortality was limited, partly due to insufficient, real-time surveillance of cancer outcomes, internationally. Elective surgery activity has decreased and cancer services have adapted rapidly, worldwide. Further research is needed to understand the impact of COVID-19 on cancer mortality and the efficacy of health system mitigation measures, globally.

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How to maintain elective treatment of breast cancer during the COVID‐19 pandemic—A cancer center experience

Abstract: How to cite this article: Leite FPM, Curi C, Sanches SM, et al. How to maintain elective treatment of breast cancer during the COVID-19 pandemic-A cancer center experience.

Cited by 7 publications

References 4 publications

The use of telemedicine to maintain breast cancer follow‐up and surveillance during the COVID‐19 pandemic

The use of telemedicine to maintain breast cancer follow‐up and surveillance during the COVID‐19 pandemic

Differences in mortality of cancer patients with COVID-19 in a Brazilian cancer center

Global elective breast- and colorectal cancer surgery performance backlogs, attributable mortality and implemented health system responses during the COVID-19 pandemic: A scoping review

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