Management of Early Breast Cancer at an Australian Cancer Centre During the Early Phase of COVID-19 Pandemic

Elissa J Zhang (1), Kirsty Stuart (2), Rina Hui (3), Rhiannon Mellor (4), Wei Wang (5), Verity Ahern (6), Farid Meybodi (7), James French (8), Elisabeth Elder (9), Meagan Brennan (10)
(1) Westmead Breast Cancer Institute, Westmead Hospital, Westmead, NSW, Australia AND Faculty of Medicine, University of New South Wales, Kensington, NSW, Australia, Australia,
(2) Westmead Breast Cancer Institute, Westmead Hospital, Westmead, NSW, Australia AND Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Westmead NSW, Australia AND Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, NSW, Australia, Australia,
(3) Westmead Breast Cancer Institute, Westmead Hospital, Westmead, NSW, Australia AND Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Westmead NSW, Australia AND Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, NSW, Australia, Austria,
(4) Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, NSW, Australia, Australia,
(5) Westmead Breast Cancer Institute, Westmead Hospital, Westmead, NSW, Australia AND Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, NSW, Australia, Australia,
(6) Westmead Breast Cancer Institute, Westmead Hospital, Westmead, NSW, Australia AND Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Westmead NSW, Australia AND Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, NSW, Australia, Australia,
(7) Westmead Breast Cancer Institute, Westmead Hospital, Westmead, NSW, Australia AND Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Westmead NSW, Australia, Australia,
(8) Westmead Breast Cancer Institute, Westmead Hospital, Westmead, NSW, Australia AND Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Westmead NSW, Australia, Australia,
(9) Westmead Breast Cancer Institute, Westmead Hospital, Westmead, NSW, Australia AND Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Westmead NSW, Australia, Australia,
(10) Westmead Breast Cancer Institute, Westmead Hospital, Westmead, NSW, Australia AND Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Westmead NSW, Australia AND School of Medicine Sydney, University of Notre Dame Australia, Darlinghurst, NSW, Australia, Australia
https://doi.org/10.32768/abc.202184318-328

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Issue
Vol 8, No 4: November 2021
Submitted
July 22, 2021
Published
October 31, 2021
Keywords:
    Early breast cancer, Cancer management, COVID-19, Breast cancer, Coronavirus, Surgery, Radiotherapy, Chemotherapy
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Abstract

Background: This study aimed to prospectively record changes to treatment for early breast cancer patients during the first wave of the COVID-19 pandemic in Australia.  The purpose was to assess the impact on breast cancer outcomes and to determine the need for any mitigative actions. 


Methods: The study was conducted in the breast cancer unit of a tertiary referral hospital. Patients with early (non-metastatic) breast malignancy discussed in multidisciplinary team meetings between March and June 2020 were included. Patients were newly diagnosed, post-operative or post-neoadjuvant chemotherapy. Standard treatment was defined by Westmead Breast Cancer Institute protocols and any variations related to the pandemic were recorded.


Results: In the study, 145 patients were included (median age 59 years). Pandemic-related changes to management were noted in 13 of 145 (9.0%) patients. Four patients experienced a delay to cancer treatments, four were not offered reconstructive/ symmetrisation surgical procedures, three had altered radiotherapy protocols and two patients were not offered enrolment to a clinical trial. These impacts affected the groups presenting with new cancers (n=7/86, 8.1%), post-operative cases (n=4/25, 16.0%) and post-neoadjuvant chemotherapy cases presenting for surgical planning (n=2/34, 5.9%). 


Conclusion: Most patients (91.0%) received standard treatment during the first wave of the pandemic. The minor variations from institutional protocols observed in this study are unlikely to affect local control or survival in this patient cohort, but close follow-up is required. Quality of life may have been affected for four patients who had downgraded or delayed reconstructive procedures.

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Authors

Elissa J Zhang
Westmead Breast Cancer Institute, Westmead Hospital, Westmead, NSW, Australia AND Faculty of Medicine, University of New South Wales, Kensington, NSW, Australia
Kirsty Stuart
Westmead Breast Cancer Institute, Westmead Hospital, Westmead, NSW, Australia AND Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Westmead NSW, Australia AND Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, NSW, Australia
Rina Hui
Westmead Breast Cancer Institute, Westmead Hospital, Westmead, NSW, Australia AND Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Westmead NSW, Australia AND Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, NSW, Australia
Rhiannon Mellor
Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, NSW, Australia
Wei Wang
Westmead Breast Cancer Institute, Westmead Hospital, Westmead, NSW, Australia AND Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, NSW, Australia
Verity Ahern
Westmead Breast Cancer Institute, Westmead Hospital, Westmead, NSW, Australia AND Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Westmead NSW, Australia AND Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, NSW, Australia
Farid Meybodi
Westmead Breast Cancer Institute, Westmead Hospital, Westmead, NSW, Australia AND Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Westmead NSW, Australia
James French
Westmead Breast Cancer Institute, Westmead Hospital, Westmead, NSW, Australia AND Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Westmead NSW, Australia
Elisabeth Elder
Westmead Breast Cancer Institute, Westmead Hospital, Westmead, NSW, Australia AND Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Westmead NSW, Australia
Meagan Brennan
Westmead Breast Cancer Institute, Westmead Hospital, Westmead, NSW, Australia AND Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Westmead NSW, Australia AND School of Medicine Sydney, University of Notre Dame Australia, Darlinghurst, NSW, Australia
meagan.brennan@sydney.edu.au (Primary Contact)
1.
J Zhang E, Stuart K, Hui R, Mellor R, Wang W, Ahern V, Meybodi F, French J, Elder E, Brennan M. Management of Early Breast Cancer at an Australian Cancer Centre During the Early Phase of COVID-19 Pandemic. Arch Breast Cancer [Internet]. 2021 Oct. 31 [cited 2024 May 19];:318-2. Available from: https://www.archbreastcancer.com/index.php/abc/article/view/443
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