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Mathelin C, Ame S, Anyanwu S, Avisar E, Boubnider WM, Breitling K, Anie HA, Conceição JC, Dupont V, Elder E, Elfgen C, Elonge T, Iglesias E, Imoto S, Ioannidou-Mouzaka L, Kappos EA, Kaufmann M, Knauer M, Luzuy F, Margaritoni M, Mbodj M, Mundinger A, Orda R, Ostapenko V, Özbaş S, Özmen V, Pagani O, Pieńkowski T, Schneebaum S, Shmalts E, Selim A, Pavel Z, Lodi M, Maghales-Costa M. Breast Cancer Management During the COVID-19 Pandemic: The Senologic International Society Survey. Eur J Breast Health 2021; 17:188-196. [PMID: 33870120 DOI: 10.4274/ejbh.galenos.2021.2021-1-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 03/09/2021] [Indexed: 01/19/2023]
Abstract
Objective In early 2020, the spread of coronavirus disease-2019 (COVID-19) led the World Health Organization to declare this disease a pandemic. Initial epidemiological data showed that patients with cancer were at high risk of developing severe forms of COVID-19. National scientific societies published recommendations modifying the patients' breast cancer (BC) management to preserve, in theory, quality oncologic care, avoiding the increased risk of contamination. The Senology International Society (SIS) decided to take an inventory of the actions taken worldwide. This study investigates COVID-19-related changes concerning BC management and analyzes the will to maintain them after the pandemic, evaluating their oncological safety consequences. Materials and Methods SIS network members participated in an online survey using a questionnaire (Microsoft® Forms) from June 15th to July 31st, 2020. Results Forty-five responses from 24 countries showed that screening programs had been suspended (68%); magnetic resonance imagines were postponed (73%); telemedicine was preferred when possible (71%). Surgeries were postponed: reconstructive (77%), for benign diseases (84%), and in patients with significant comorbidities (66%). Chemotherapy and radiotherapy protocols had been adapted in 28% of patients in both. Exception for telemedicine (34%), these changes in practice should not be continued. Conclusion The SIS survey showed significant changes in BC's diagnosis and treatment during the first wave of the COVID-19 pandemic, but most of these changes should not be maintained. Indeed, women have fewer severe forms of COVID-19 and are less likely to die than men. The risk of dying from COVID-19 is more related to the presence of comorbidities and age than to BC. Stopping screening and delaying treatment leads to more advanced stages of BC. Only women aged over 65 with BC under treatment and comorbidities require adaptation of their cancer management.
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Affiliation(s)
- Carole Mathelin
- Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg Cedex, France.,Immediate the Senology International Society (SIS) Past President, France
| | - Shanti Ame
- Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg Cedex, France
| | - Stanley Anyanwu
- The Senology International Society Vice-President for Africa, Nigeria
| | - Eli Avisar
- Miller School of Medicine, University of Miami, USA
| | | | | | | | | | | | - Elisabeth Elder
- Westmead Breast Cancer Institute, University of Sydney, Australia
| | | | | | - Edelmiro Iglesias
- The Senology International Society (SIS) Vice-President for Europe, Spain
| | | | | | - Elisabeth A Kappos
- Breast Center and Department of Plastic, Reconstructive, Aesthetic and Handsurgery, University Hospital Basel, Switzerland
| | | | - Michael Knauer
- Breast Center Eastern Switzerland, St. Gallen, Switzerland
| | - Franck Luzuy
- Department of Breast Surgery, Hirslanden Clinic, Geneva, Switzerland
| | | | - Mamadou Mbodj
- Department of Nuclear Medicine, General Hospital Idrissa POUYE, Dakar, Senegal
| | | | - Ruben Orda
- The Senology International Society (SIS) International School of Senology, Israel
| | | | | | - Vahit Özmen
- The Senology International Society (SIS) Standing Committee, Turkey
| | - Olivia Pagani
- Department of Oncology, Breast Unit and Institute of Oncology of Southern Switzerland
| | | | | | - Ekaterina Shmalts
- Department of Oncology, Multi-field Clinical Medical Centre "Medical City", Tyumen, Russia
| | - Ashraf Selim
- Department of Radiology, Cairo University, Egypt
| | - Zotov Pavel
- Department of Oncology, Tyumen State Medical University, Russia
| | - Massimo Lodi
- Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg Cedex, France
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