Strategies for Breast Cancer Surgery During & After COVID-19 Pandemic

Main Article Content

Germana Lissidini
Gabriel Farante
Jose Maria Vila Vives
Arwa Ahmed Ashoor
Antonio Toesca
Francisco Ripoll-Orts
Paolo Arnone
Giuseppe Curigliano
Paolo Veronesi

Keywords

Coronavirus, COVID-19, Breast Cancer, Breast Surgery

Abstract

Background: In December 2019, a severe acute respiratory syndrome coronavirus 2 (SARS-COV-2), also named “COVID-19”, has produced a global pandemic and has seriously affected many health systems around the world. Since the World Health Organization (WHO) declared the novel COVID-19 outbreak as a global pandemic, many international societies and groups of experts have published clinical guidelines and recommendations for surgical management of breast cancer patients in this time of crisis and issued COVID guidelines to prioritize surgery where time is critical and it cannot be deferred.
Methods: In this study, we review current recommendations for breast cancer surgery during the COVID-19 pandemic and propose a plan for future waves of the current pandemic while minimizing the risk of the contagious disease and oversaturating the health systems regarding the burden of accumulating untreated disease.
Results: We create a critical and constructive vision from learnt lessons for similar future situations and propose a moving forward plan during and after the COVID-19 pandemic.  
Conclusion: Although in many parts of world, it would appear that now we are past the peak of the COVID-19 pandemic, we still face as uncertainty as to the future course of the pandemic and the challenges of the second wave. It is important to reappraise continuously the guidance and to emphasize the need for new protocols under new norms to continue to deliver breast cancer surgery safely.

References

1. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. New Engl J Med. 2020;382(8):727–33. doi: 10.1056/NEJMoa2001017.
2. World Health Organization. Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV), Jan 30th 2020. [Internet]. Available from: https://www.who.int/news/item/30-01-2020-statement-on-the-second-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-outbreak-of-novel-coronavirus-(2019-ncov).
3. Medicine. JHU and. Coronavirus Resource Center [Internet]. [cited 2021 Aug 15]. Available from: http://coronavirus.jhu.edu/.
4. Tasoulis MK, Roche N, MacNeill F. Rationalizing breast cancer surgery during the COVID-19 pandemic. Eur J Surg Oncol. 2020;46(6):1192–3. doi: 10.1016/j.ejso.2020.04.049.
5. England A of BS at TRC of S of. Statement from the association of breast surgery, 15th March 2020. [Internet]. [cited 2021 Jul 15]. Available from: https://associationofbreastsurgery.org.uk/media/252009/abs-statement-150320-v2.pdf.
6. England. B-TA for CS as TRC of S of. Pragmatic management of breast cancer during COVID-19 [Internet]. [cited 2021 Jul 15]. Available from: https://baso.org.uk/media/98159/covid_19_and_breast_cancer_march_2020.pdf.
7. Oncology. ES of M. ESMO management and treatment adapted recommendations in the COVID-19 era: breast cancer [Internet]. [cited 2021 Jul 15]. Available from: http://www.esmo.org/guidelines/cancer-patient-management-during-the-covid-19-pandemic/breast-cancer-in-the-covid-19-era 18.
8. Surgeons AC of. COVID 19: Elective Case Triage Guidelines for Surgical Care. Developed by the COVID 19 Pandemic Breast Cancer Consortium (this consortium is made up of representatives from the NAPBC, CoC, ASBrS, and NCCN) [Internet]. [cited 2021 Jul 15]. Available from: https://www.facs.org/-/media/files/covid19/guidance_for_triage_of_nonemergent_surgical_procedures_breast_cancer.ashx.
9. Health O, Ontario. CC. Pandemic Planning Clinical Guideline for Patients with Cancer. March 10 2020 [Internet]. [cited 2021 Jul 15]. Available from: https://www.accc-cancer.org/docs/documents/cancer-program-fundamentals/oh-cco-pandemic-planning-clinical-guideline_final_2020-03-10.pdf
10. Oncology S of S. Resource for management options of breast cancer during COVID-19 [Internet]. [cited 2021 Jul 15]. Available from: https://www.surgonc.org/wp-content/uploads/2020/03/Breast-Resource-during-COVID-19-3.30.20.pdf
11. Kawate T, Yoshida A, Sugae S, Asaga S, Kaise H, Saji S, et al. Recommendations for the management of breast cancer patients during the COVID-19 pandemic from the Japan Breast Cancer Society. Breast Cancer-tokyo. 2021;28(2):247–53. doi: 10.1007/s12282-020-01214-9.
12. Zealand TBS of A and N. Guidelines relating to the COVID-19 pandemic [Internet]. [cited 2021 Jul 15]. Available from: http://www.breastsurganz.org/news/guidelines-relating-to-the-covid-19-pandemic.
13. Vicini E, Galimberti V, Naninato P, Vento AR, Fontana SKR, Veronesi P. COVID-19: The European institute of oncology as a “hub” centre for breast cancer surgery during the pandemic in Milan (Lombardy region, northern Italy) - A screenshot of the first month. Eur J Surg Oncol. 2020;46(6):1180–1. doi: 10.1016/j.ejso.2020.04.026.
14. Curigliano G, Cardoso MJ, Poortmans P, Gentilini O, Pravettoni G, Mazzocco K, et al. Recommendations for triage, prioritization and treatment of breast cancer patients during the COVID-19 pandemic. Breast. 2020;52:8–16. doi: 10.1016/j.breast.2020.04.006.
15. Dietz JR, Moran MS, Isakoff SJ, Kurtzman SH, Willey SC, Burstein HJ, et al. Recommendations for prioritization, treatment, and triage of breast cancer patients during the COVID-19 pandemic. the COVID-19 pandemic breast cancer consortium. Breast Cancer Res Tr. 2020;181(3):487–97. doi: 10.1007/s10549-020-05644-z.
16. Al‐Shamsi HO, Alhazzani W, Alhuraiji A, Coomes EA, Chemaly RF, Almuhanna M, et al. A Practical Approach to the Management of Cancer Patients During the Novel Coronavirus Disease 2019 (COVID‐19) Pandemic: An International Collaborative Group. Oncologist. 2020;25(6):e936–45. doi: 10.1634/theoncologist.2020-0213.
17. System NH. Guidance for trusts on the management of non-coronavirus patients requiring acute treatment: cancer (Nov 2020). [Internet]. Available from: https://www.nice.org.uk/Media/Default/About/COVID-19/Specialty-guides/cancer-and-COVID-19.pdf.
18. Thomas D, Maxwell W, Archer C, Rigg A, Hickish T, Dent J, et al. Abstract OT3-17-03: Impact of the Oncotype DX breast cancer assay on treatment decisions in a UK population of patients with oestrogen receptor positive early breast cancer with 1-3 lymph nodes positive who are candidates for chemotherapy, but for whom the benefits are uncertain - Interim results. Ongoing Clin Trials. 2020;OT3-17-03-OT3-17–03. doi: 10.1158/1538-7445.
19. Brunt AM, Haviland J, Sydenham M, Algurafi H, Alhasso A, Bliss P, et al. FAST Phase III RCT of Radiotherapy Hypofractionation for Treatment of Early Breast Cancer: 10-Year Results (CRUKE/04/015). Int J Radiat Oncol Biology Phys. 2018;102(5):1603–4. doi: 10.1016/j.ijrobp.2018.08.049.
20. Mansfield SA, Abdel‐Rasoul M, Terando AM, Agnese DM. Timing of Breast Cancer Surgery—How Much Does It Matter? Breast J. 2017;23(4):444–51. doi: 10.1111/tbj.12758.
21. Finley C, Prashad A, Camuso N, Daly C, Aprikian A, Ball CG, et al. Guidance for management of cancer surgery during the COVID-19 pandemic. Can J Surg. 2020;63(2):S2–4. doi: 10.1503/cjs.005620.
22. Berger-Richardson D, Ko G, Hong NJL. Preparing for the Renaissance: Treating Breast Cancer during the COVID-19 Pandemic and Planning for a Safe Re-Emergence to Routine Surgical Care within a Universal Health Care System. Curr Oncol. 27(3):163–8. doi: 10.3747/co.27.6699.
23. Seely JM, Scaranelo AM, Yong-Hing C, Appavoo S, Flegg C, Kulkarni S, et al. COVID-19: Safe Guidelines for Breast Imaging During the Pandemic. Can Assoc Radiologists J. 2020;71(4):459–69. doi: 10.1177/0846537120928864.
24. Maringe C, Spicer J, Morris M, Purushotham A, Nolte E, Sullivan R, et al. The impact of the COVID-19 pandemic on cancer deaths due to delays in diagnosis in England, UK: a national, population-based, modelling study. Lancet Oncol. 2020;21(8):1023–34. doi: 10.1016/S1470-2045(20)30388-0.
25. Bartlett DL, Howe JR, Chang G, Crago A, Hogg M, Karakousis G, et al. Management of Cancer Surgery Cases During the COVID-19 Pandemic: Considerations. Ann Surg Oncol. 2020;27(6):1717–20. doi: 10.1245/s10434-020-08461-2.
26. Shin DW, Cho J, Kim SY, Guallar E, Hwang SS, Cho B, et al. Delay to Curative Surgery Greater than 12 Weeks Is Associated with Increased Mortality in Patients with Colorectal and Breast Cancer but Not Lung or Thyroid Cancer. Ann Surg Oncol. 2013;20(8):2468–76. doi: 10.1245/s10434-013-2957-y.
27. Yin K, Singh P, Drohan B, Hughes KS. Breast imaging, breast surgery, and cancer genetics in the age of COVID‐19. Cancer. 2020;126(20):4466–72. doi: 10.1002/cncr.33113.
28. Sud A, Torr B, Jones ME, Broggio J, Scott S, Loveday C, et al. Effect of delays in the 2-week-wait cancer referral pathway during the COVID-19 pandemic on cancer survival in the UK: a modelling study. Lancet Oncol. 2020;21(8):1035–44. doi: 10.1016/S1470-2045(20)30392-2.
29. Christensen S, Zachariae R, Jensen AB, Væth M, Møller S, Ravnsbæk J, et al. Prevalence and risk of depressive symptoms 3–4 months post-surgery in a nationwide cohort study of Danish women treated for early stage breast-cancer. Breast Cancer Res Tr. 2009;113(2):339–55. doi: 10.1007/s10549-008-9920.
30. Martin M, Guerrero-Zotano A, Montero Á, Jara C, Filipovich E, Rojo F, et al; GEICAM Spanish Breast Cancer Group Steering Committee. GEICAM Guidelines for the Management of Patients with Breast Cancer During the COVID-19 Pandemic in Spain. Oncologist. 2020 Sep;25(9):e1339-e1345. doi: 10.1634/theoncologist.2020-0363.
31. Ballardini B, Cavalli M, Manfredi GF, Sangalli C, Galimberti V, Intra M, et al. Surgical treatment of breast lesions at a Day Centre: Experience of the European Institute of Oncology. Breast. 2016;27:169–74. doi: 10.1016/j.breast.2016.04.002.
32. England A of BS as TRC of S of. Association of Breast Surgery Statement, 27th April 2020 [Internet]. [cited 2021 Jul 15]. Available from: https://associationofbreastsurgery.org.uk/media/252026/abs-statement-270420.pdf.
33. Zhang L, Zhu F, Xie L, Wang C, Wang J, Chen R, et al. Clinical characteristics of COVID-19-infected cancer patients: a retrospective case study in three hospitals within Wuhan, China. Ann Oncol. 2020;31(7):894–901. doi: 10.1016/j.annonc.2020.03.296.
34. Liang W, Guan W, Chen R, Wang W, Li J, Xu K, et al. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol. 2020;21(3):335–7. doi: 10.1016/S1470-2045(20)30096-6.
35. Ji C, Singh K, Luther AZ, Agrawal A. Is Elective Cancer Surgery Safe During the COVID-19 Pandemic? World J Surg. 2020;44(10):3207–11. doi: 10.1007/s00268-020-05720-x.
36. MacInnes EG, Piper J, Tait C, Waterworth A, Achuthan R, Hogan B, et al. Breast Cancer Surgery During the COVID-19 Pandemic Peak in the UK: Operative Outcomes. Cureus J Medical Sci. 2020;12(7):e9280. doi: 10.7759/cureus.9280.
37. Bortolato B, Hyphantis TN, Valpione S, Perini G, Maes M, Morris G, et al. Depression in cancer: The many biobehavioral pathways driving tumor progression. Cancer Treat Rev. 2017;52:58–70. doi: 10.1016/j.ctrv.2016.11.004.
38. Reis JC, Antoni MH, Travado L. Emotional distress, brain functioning, and biobehavioral processes in cancer patients: a neuroimaging review and future directions. Cns Spectrums. 2020;25(1):79–100. doi: 10.1017/S1092852918001621.

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