Modifications in Breast Cancer Guidelines in COVID-19 Pandemic; An Iranian Consensus
Main Article Content
Keywords
Coronavirus, Breast cancer guidelines, COVID-19
Abstract
Background: In March 2020, the World Health Organization declared the novel COVID-19 infection a pandemic. Among high-risk patients infected by the virus, breast cancer patients are vulnerable to present more severe infections. Iran is among the countries with a high incidence of COVID-19 , and most of the routine activities of medical centers are affected by the epidemic disease. Thus, there is a need to make some modifications to international protocols for dealing with breast cancer in the affected countries.
Methods: The headings of breast cancer management protocols have been discussed among the university-affiliated professors in different disciplines involved in breast cancer management. The discussions were done through a “WhatsApp” group considering the tiles and the latest news about COVID-19. Under each title, we provide the consensus of all members in the related disciplines.
Recommendations and Conclusion: In each specialty, all members agreed to choose minimal intervention. The modifications aim to reduce the workload of the medical centers as well as to provide the least interface of the patients with the medical centers. The members know that some recommendations may interfere with the routine best-practice recommendations and decrease the quality measures in the patient's outcome. Therefore, these recommendations are valid just in epidemic COVID-19 situation in the country.
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2. Liang W, Guan W, Chen R, Wang W, Li J, et al. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol. 2020;21(3):335-7.
3. Wang H, Zhang L. Risk of COVID-19 for patients with cancer. Lancet Oncol. 2020.
4. Xia Y, Jin R, Zhao J, Li W, Shen H. Risk of COVID-19 for cancer patients. Lancet Oncol. 2020.
5. Zhou F, Yu T, Du R, Fan G, Liu Y, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020.
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7. Kamboj M, Sepkowitz KA. Nosocomial infections in patients with cancer. Lancet Oncol. 2009;10(6):589-97.
8. Li JY, Duan XF, Wang LP, Xu YJ, Huang L, et al. Selective depletion of regulatory T cell subsets by docetaxel treatment in patients with nonsmall cell lung cancer. J Immunol Res. 2014;2014:286170.
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17. Gagliato Dde M, Gonzalez-Angulo AM, Lei X, Theriault RL, Giordano SH, et al. Clinical impact of delaying initiation of adjuvant chemotherapy in patients with breast cancer. J Clin Oncol. 2014;32(8):735-44.
18. Chavez-MacGregor M, Clarke CA, Lichtensztajn DY, Giordano SH. Delayed initiation of adjuvant chemotherapy among patients with breast cancer. JAMA oncology. 2016;2(3):322-9.
19. Shannon C, Ashley S, Smith I. Does timing of adjuvant chemotherapy for early breast cancer influence survival? Journal of clinical oncology. 2003;21(20):3792-7.
20. Lohrisch C, Paltiel C, Gelmon K, Speers C, Taylor S, et al. Impact on survival of time from definitive surgery to initiation of adjuvant chemotherapy for early-stage breast cancer. J Clin Oncol. 2006;24(30):4888-94.
21. Kupstas AR, Hoskin TL, Day CN, Habermann EB, Boughey JC. Effect of Surgery Type on Time to Adjuvant Chemotherapy and Impact of Delay on Breast Cancer Survival: A National Cancer Database Analysis. Ann Surg Oncol. 2019;26(10): 3240-9.
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23. Nitz U, Gluz O, Clemens M, Malter W, Reimer T, et al. West German Study PlanB Trial: adjuvant four cycles of epirubicin and cyclophosphamide plus docetaxel versus six cycles of docetaxel and cyclophosphamide in HER2-negative early breast cancer. Journal of Clinical Oncology. 2019;37(10):799-808.
24. What should medical oncologists know about COVID-19? 2020 [Available from: https://www.esmo.org/newsroom/covid-19-and-cancer/q-a-on-covid-19.]
25. Kindts I, Laenen A, Depuydt T, Weltens C. Tumour bed boost radiotherapy for women after breast-conserving surgery. Cochrane Database Syst Rev. 2017;11:CD011987.
26. Kim K, Chie EK, Han W, Noh D-Y, Ha SW. Impact of delayed radiotherapy on local control in node-negative breast cancer patients treated with breast-conserving surgery and adjuvant radiotherapy without chemotherapy. Tumori Journal. 2011;97(3):341-4.
27. Livi L, Borghesi S, Saieva C, Meattini I, Rampini A, et al. Radiotherapy timing in 4,820 patients with breast cancer: university of florence experience. International Journal of Radiation Oncology* Biology* Physics. 2009;73(2):365-9.
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29. van Maaren MC, Bretveld RW, Jobsen JJ, Veenstra RK, Groothuis-Oudshoorn CG, et al. The influence of timing of radiation therapy following breast-conserving surgery on 10-year disease-free survival. Br J Cancer. 2017;117(2):179-88.
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Shahi F, Mirzania M, Aghili M, Dabiri M, Seifi S, Bary A, Ansarinejad N, Rezvani A, Rad S, Shahi A, Elahi A, Kaviani A. Modifications in Breast Cancer Guidelines in COVID-19 Pandemic; An Iranian Consensus. Arch Breast Cancer [Internet]. 2020 Mar. 22 [cited 2021 Dec. 4];:14-21. Available from: https://archbreastcancer.com/index.php/abc/article/view/280
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