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Ge R. Key points of anti-tumor treatment in breast cancer patients with SARS-CoV-2 infection. TRANSLATIONAL BREAST CANCER RESEARCH : A JOURNAL FOCUSING ON TRANSLATIONAL RESEARCH IN BREAST CANCER 2023; 4:13. [PMID: 38751467 PMCID: PMC11093019 DOI: 10.21037/tbcr-23-10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 04/15/2023] [Indexed: 05/18/2024]
Abstract
Internationally, the outbreak of coronavirus disease 2019 (COVID-19) has become the most serious public health emergency. With the adjustment of the prevention and control policies, China downgraded the management of COVID-19 from Class A to Class B, causing new challenges in the clinical management of patients with breast cancer. It is necessary to formulate clinical strategies for timely and reasonable anti-tumor treatment after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. By combing the relevant evidence and summarizing the anti-tumor treatment experience for breast cancer patients with SARS-CoV-2 infection in various regions, the expert panel of the Breast Cancer Professional Committee of the Chinese Society of Clinical Oncology (CSCO-BC) discussed and voted on hot and difficult issues of this situation timely. Based on the vote results, combined with domestic and foreign guidelines and consensus, the key points of treatment and management of breast cancer patients who were infected with COVID-19 have been established to provide suggestions and recommendations for clinical practice, such as restart time of anti-tumor treatment, application of anti-tumor drugs and other considerations. In the formulation of this key point, we mainly focus on mild to moderate and asymptomatic infection patients who account for the largest proportion of COVID-19 patients, and propose diagnosis and treatment recommendations for breast cancer patients with different infections and after SARS-CoV-2 infection, aiming to provide a reference for clinical diagnosis and treatment.
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Affiliation(s)
- Rui Ge
- Department of General Surgery, Huadong Hospital Affiliated to Fudan University, Shanghai, China
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Bayard S, Fasano G, Gillot T, Bratton B, Ibala R, Taylor Fortson K, Newman L. Breast Cancer Disparities and the Digital Divide. CURRENT BREAST CANCER REPORTS 2022; 14:205-212. [PMID: 36467667 PMCID: PMC9703401 DOI: 10.1007/s12609-022-00468-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2022] [Indexed: 11/29/2022]
Abstract
Purpose of Review Socioeconomically disadvantaged populations and minority groups suffer from high breast cancer mortality, a disparity caused by decreased access to specialty care, lower treatment adherence, co-morbidities, and genetic predisposition for biologically aggressive breast tumor subtypes. Telehealth has the potential to mitigate breast cancer disparities by increasing access to specialty care and health information. However, unequal access to high-speed/broadband internet service and telehealth itself magnifies breast cancer disparities in vulnerable populations. This review evaluates the impact of the digital divide on breast cancer outcomes, as well as strategies for leveraging telehealth to reduce breast cancer disparities. Recent Findings There is a paucity of research specific to employing telehealth to address breast cancer disparities. Previous studies provide examples of telehealth utilization for increasing screening mammography, in addition to improving access to breast cancer care, including breast cancer specialist, nurse navigators, and clinical trials. Telehealth can also be used as an approach to risk reduction, with strategies to support weight management and genetic testing. Summary Eliminating the digital divide holds enormous potential for mitigating breast cancer disparities through an intentional focus on improving access to telehealth. With increased accessibility, resource allocation, and improved digital infrastructure, telehealth can be used to address disparities in early detection, quality of breast cancer care, treatment adherence, and risk assessment. Further research is essential to elucidate best practices in breast cancer telehealth approaches in underserved communities.
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Affiliation(s)
- Solange Bayard
- Department of Surgery, Weill Cornell Medicine, 525 E 68Th Street, New York-PresbyterianNew York, NY 10065 USA
| | - Genevieve Fasano
- Department of Surgery, Weill Cornell Medicine, 525 E 68Th Street, New York-PresbyterianNew York, NY 10065 USA
| | - Tamika Gillot
- Department of Surgery, Weill Cornell Medicine, 525 E 68Th Street, New York-PresbyterianNew York, NY 10065 USA
| | - Brenden Bratton
- Department of Surgery, Weill Cornell Medicine, 525 E 68Th Street, New York-PresbyterianNew York, NY 10065 USA
| | - Reine Ibala
- Department of Surgery, Weill Cornell Medicine, 525 E 68Th Street, New York-PresbyterianNew York, NY 10065 USA
| | - Katherine Taylor Fortson
- Department of Surgery, Weill Cornell Medicine, 525 E 68Th Street, New York-PresbyterianNew York, NY 10065 USA
| | - Lisa Newman
- Department of Surgery, Weill Cornell Medicine, 525 E 68Th Street, New York-PresbyterianNew York, NY 10065 USA
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Friedrich AKU, DiComo JA, Golshan M. The Impact of COVID-19 on Breast Surgery Fellowships. CURRENT BREAST CANCER REPORTS 2021; 13:235-240. [PMID: 34703524 PMCID: PMC8531885 DOI: 10.1007/s12609-021-00430-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2021] [Indexed: 11/03/2022]
Abstract
Purpose of Review Across the world, medical training has been affected by the COVID-19 virus and this has changed the way physicians are educated. What is less clear is the effect of the pandemic on breast surgical oncology fellows who were in training during this time. This review discusses the experience of breast surgical oncology fellows during the pandemic and how fellowships adapted to preserve the educational experience and conserve the quality of training. Recent Findings The challenges and changes experienced by breast surgery fellows during the COVID-19 pandemic have proved to be sudden shifts in not only fellowship training, but future patient care and research opportunities, all while confronting the global impact of a deadly pandemic. While experiences between fellowships varied, the similarities and differences encountered highlight the regional and temporal differences in how fellowships responded to the pandemic. Summary Breast surgical oncology fellowship is one year long, with every day allocated to ensure the surgeon has a deep understanding of the multidisciplinary approach to this ever-evolving field. As the pandemic spread and affected different regions with varying severity, elective cases were canceled, resources were re-allocated, and uncertainty abounded. At the same time, novel approaches to fellowship training were rapidly implemented. It will take time and additional research to fully understand the long-term consequences for trainees affected during their breast surgery fellowship.
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Affiliation(s)
- Ann-Kristin U Friedrich
- Department of Surgery, Yale University School of Medicine, 310 Cedar Street, New Haven, CT 06510 USA
| | - Joseph A DiComo
- Department of Surgery, Women and Infant's, Providence, RI USA
| | - Mehra Golshan
- Department of Surgery, Yale University School of Medicine, 310 Cedar Street, New Haven, CT 06510 USA
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Siavashpour Z, Goharpey N, Mobasheri M. Radiotherapy based management during Covid-19 pandemic - A systematic review of presented consensus and guidelines. Crit Rev Oncol Hematol 2021; 164:103402. [PMID: 34214608 PMCID: PMC8242203 DOI: 10.1016/j.critrevonc.2021.103402] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 02/17/2021] [Accepted: 06/18/2021] [Indexed: 01/18/2023] Open
Abstract
Treatment management of cancer patients in the radiation oncology departments during the current COVID-19 pandemic is challenging. A systematic review of published consensus/guidelines on the role of radiotherapy prioritization, suggested treatment protocols, and set up management was undertaken based on the PRISMA protocol and through PubMed/PMC, Scopus, Google Scholar, Web of Science databases until 01/20/2021. One hundred and sixty-eight publications or regional consensus were included. Summary of recommendations contained: (1) using hypo-fractionated (Hypo-F) regimens for therapeutic/palliative indications, (2) delaying radiotherapy for several weeks or until pandemic over, (3) omitting radiotherapy by replacement of alternative therapies or active surveillance, (4) applying safer patients' setup and preparation protocols, (5) developing telemedicine/telehealth service. To conclude, it is essential to carefully weigh the risk of exposure to COVID-19 infection and the benefit of treating cancer patients during the pandemic. Trying to have a global guideline facing this or any other probable crisis is crucial for health care service.
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Affiliation(s)
- Zahra Siavashpour
- Radiotherapy Oncology Department, Shohada-e Tajrish Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Neda Goharpey
- Radiotherapy Oncology Department, Shohada-e Tajrish Educational Hospital, Tehran, Iran.
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Triple-Negative Breast Cancer and the COVID-19 Pandemic: Clinical Management Perspectives and Potential Consequences of Infection. Cancers (Basel) 2021; 13:cancers13020296. [PMID: 33467411 PMCID: PMC7830590 DOI: 10.3390/cancers13020296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 01/09/2021] [Accepted: 01/11/2021] [Indexed: 12/30/2022] Open
Abstract
Simple Summary The Coronavirus disease (COVID-19) pandemic has resulted in challenges to cancer management, exacerbated by limited clinical resources and caution in preventing COVID-19 transmission between patients and healthcare professionals. The neglect of breast cancer (in particular, triple-negative breast cancer (TNBC)) patients during the outbreak could negatively impact their overall survival, as delays in treatment and consultations provide vital time for tumor progression and metastasis. Herein, we review the shifting clinical management of TNBCs during the COVID-19 outbreak. The suggested treatment recommendations can hopefully minimize virus exposure without sacrificing patient care during times when healthcare systems are overburdened. Further, we review published RNA-seq data to assess the theoretical infectability of metastatic TNBCs to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection. These analyses highlight the potential of the virus to infect TNBC cells. Given the known increased susceptibility of cancer cells to viral infection, this additional host cell reservoir may make patients with metastatic disease particularly vulnerable to COVID-19 morbidities. Abstract The COVID-19 pandemic has caused the need for prioritization strategies for breast cancer treatment, where patients with aggressive disease, such as triple-negative breast cancer (TNBC) are a high priority for clinical intervention. In this review, we summarize how COVID-19 has thus far impacted the management of TNBC and highlighted where more information is needed to hone shifting guidelines. Due to the immunocompromised state of most TNBC patients receiving treatment, TNBC management during the pandemic presents challenges beyond the constraints of overburdened healthcare systems. We conducted a literature search of treatment recommendations for both primary and targeted TNBC therapeutic strategies during the COVID-19 outbreak and noted changes to treatment timing and drugs of choice. Further, given that SARS-CoV-2 is a respiratory virus, which has systemic consequences, management of TNBC patients with metastatic versus localized disease has additional considerations during the COVID-19 pandemic. Published dataset gene expression analysis of critical SARS-CoV-2 cell entry proteins in TNBCs suggests that the virus could in theory infect metastasized TNBC cells it contacts. This may have unforeseen consequences in terms of both the dynamics of the resulting acute viral infection and the progression of the chronic metastatic disease. Undoubtedly, the results thus far suggest that more research is required to attain a full understanding of the direct and indirect clinical impacts of COVID-19 on TNBC patients.
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Zimmerman BS, Seidman D, Berger N, Cascetta KP, Nezolosky M, Trlica K, Ryncarz A, Keeton C, Moshier E, Tiersten A. Patient Perception of Telehealth Services for Breast and Gynecologic Oncology Care during the COVID-19 Pandemic: A Single Center Survey-based Study. J Breast Cancer 2020; 23:542-552. [PMID: 33154829 PMCID: PMC7604367 DOI: 10.4048/jbc.2020.23.e56] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 09/27/2020] [Indexed: 12/11/2022] Open
Abstract
Prior to the coronavirus disease 2019 (COVID-19) pandemic, telehealth was rarely utilized for oncologic care in metropolitan areas. Our large New York City based outpatient breast/gynecologic cancer clinic administered an 18-question survey to patients from March to June 2020, to assess the perceptions of the utility of telehealth medicine. Of the 622 patients, 215 (35%) completed the survey, and of the 215 respondents, 74 (35%) had participated in a telehealth visit. We evaluated the use of telehealth services using the validated Service User Technology Acceptability Questionnaire. Sixty-eight patients (92%) reported that telehealth services saved them time, 54 (73%) reported telehealth increased access to care, and 58 (82%) reported telehealth improved their health. Overall, 67 (92%) of patients expressed satisfaction with the use of telehealth services for oncologic care during the COVID-19 pandemic. Telehealth services should be carefully adopted as an addition to in-person clinical care of patients with cancer.
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Affiliation(s)
- Brittney S Zimmerman
- Department of Hematology/Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Danielle Seidman
- Department of Hematology/Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Natalie Berger
- Department of Hematology/Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Krystal P Cascetta
- Department of Hematology/Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Michelle Nezolosky
- Department of Hematology/Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kara Trlica
- Department of Hematology/Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alisa Ryncarz
- Department of Hematology/Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Caitlin Keeton
- Department of Hematology/Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Erin Moshier
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Amy Tiersten
- Department of Hematology/Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Schäfer C. [How should radiotherapy for breast cancer be changed in the current times of the pandemic?]. DER ONKOLOGE : ORGAN DER DEUTSCHEN KREBSGESELLSCHAFT E.V 2020:1-4. [PMID: 32905043 PMCID: PMC7463091 DOI: 10.1007/s00761-020-00829-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Christof Schäfer
- MVZ Strahlentherapie, Barmherzige Brüder, MVZ Klinikum Straubing, St.-Elisabeth-Str. 23, 94315 Straubing, Deutschland
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Garg PK, Kaul P, Choudhary D, Singh MP, Tiwari AR. Cancer surgery in the era of COVID-19 pandemic: Changing dynamics. J Surg Oncol 2020; 122:1262-1263. [PMID: 32761619 PMCID: PMC7436129 DOI: 10.1002/jso.26156] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 07/28/2020] [Indexed: 12/16/2022]
Affiliation(s)
- Pankaj Kumar Garg
- Department of Surgical Oncology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Pallvi Kaul
- Department of Surgical Oncology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Deepti Choudhary
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Mahendra Pal Singh
- Department of Surgical Oncology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Ajeet Ramamani Tiwari
- Department of Surgical Oncology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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