The Impact of the COVID-19 Pandemic on Surgical Management of Breast Cancer: Global Trends and Future Perspectives

The oncologist

article

Nicola Rocco¹  Andreas Karakatsanis²  Anna Maglia⁴  Marco Mele⁵  Nahid Nafissi⁶  Pedro Santos Ferreira⁷  Wafa Taher⁸  Antonio Tejerina⁵  Alessio Vinci⁹  Maurizio Nava¹  Giuseppe Catanuto¹  Giacomo Montagna^1,10  Rosa Di Micco^1,11  John Benson^1,13  Carmen Criscitiello^1,15  Li Chen^1,16  Bruno Di Pace^1,14  Antonio Jesus Esgueva Colmenarejo^1,19  Yves Harder^1,18 

[1] Group for Reconstructive and Therapeutic Advancements (G.Re.T.A.);Section for Breast Surgery, Department of Surgery, Uppsala University Hospital;Department for Surgical Sciences, Uppsala University;Multidisciplinary Breast Unit, Azienda Ospedaliera Cannizzaro;Breast Surgery Department, Herlev and Gentofte Hospital;Department of Breast Surgery, Iran University of Medical Sciences;Breast Unit, Setubal Medical Center;Northampton General Hospital, United Kingdom;Department of Breast Surgery, Ninewells Hospital and Medical School, United Kingdom;Department of Surgery, Memorial Sloan Kettering Cancer Center;San Raffaele University and Research Hospital;Department of Clinical Medicine and Surgery, University of Naples Federico II;Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, United Kingdom;School of Medicine, Anglia Ruskin University, United Kingdom;European Institute of Oncology (IEO) IRCCS;Breast Center, Southwest Hospital, China Army Medical University;Department of Medicine, ” PhD School of Translational Medicine of Development and Active Aging, University of Salerno;Department of Plastic and Reconstructive Surgery, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, United Kingdom;Breast Cancer Unit, Clinica Universidad de Navarra;Second Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI)

关键词: Breast cancer surgery;    COVID-19;    Triage;    Surgical priorities;    Alternatives to surgery;   

DOI  :  10.1002/onco.13560

学科分类：地质学

来源: AlphaMed Press Incorporated

【 摘 要 】

Introduction The rapid spread of COVID-19 across the globe is forcing surgical oncologists to change their daily practice. We sought to evaluate how breast surgeons are adapting their surgical activity to limit viral spread and spare hospital resources. Methods A panel of 12 breast surgeons from the most affected regions of the world convened a virtual meeting on April 7, 2020, to discuss the changes in their local surgical practice during the COVID-19 pandemic. Similarly, a Web-based poll based was created to evaluate changes in surgical practice among breast surgeons from several countries. Results The virtual meeting showed that distinct countries and regions were experiencing different phases of the pandemic. Surgical priority was given to patients with aggressive disease not candidate for primary systemic therapy, those with progressive disease under neoadjuvant systemic therapy, and patients who have finished neoadjuvant therapy. One hundred breast surgeons filled out the poll. The trend showed reductions in operating room schedules, indications for surgery, and consultations, with an increasingly restrictive approach to elective surgery with worsening of the pandemic. Conclusion The COVID-19 emergency should not compromise treatment of a potentially lethal disease such as breast cancer. Our results reveal that physicians are instinctively reluctant to abandon conventional standards of care when possible. However, as the situation deteriorates, alternative strategies of de-escalation are being adopted. Implications for Practice This study aimed to characterize how the COVID-19 pandemic is affecting breast cancer surgery and which strategies are being adopted to cope with the situation.

【 授权许可】

CC BY|CC BY-NC