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DOI: 10.5935/2526-8732.20190024
Breast oncology and the COVID-19 pandemic: Recommendations from the Brazilian Society of Clinical Oncology (SBOC)
Câncer de mama na pandemia de COVID-19: Recomendações da Sociedade Brasileira de Oncologia Clínica (SBOC)
Financial support: none to declare.ABSTRACT
The current pandemic moment of severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) has completely changed health services, with most services being directed to the treatment of affected patients. Even during this critical period, cancer patients need to be treated, as delayed treatment can compromise the chances of a cure. The Brazilian Society of Clinical Oncology (SBOC) has developed recommendations to guide decisions in breast cancer treatment during the SARS-CoV-2 pandemic through their Breast Tumors Committee. Due to the scarcity of relevant data, discussions on systemic treatment and surgical decisions related to breast cancer biological sub- types, chemotherapy schemes, anti-HER2 therapy, adjuvant endocrine therapy, breast surgery, radiotherapy, follow-up and routine exams, long-term central venous catheters, bisphosphonate and denosumab, genetic counseling and metastatic disease were evaluated and recommendations were issued. For newly diagnosed breast cancer, if appropriate, start systemic treatment with neoadjuvant endocrine therapy or neoadjuvant chemotherapy (NACT) with anti-HER2 blockage if HER2 positive disease. Surgery should be promptly considered if disease progression during NACT, malignant phyllodes tumor or breast sarcoma. These recommendations should be adjusted according to the reality of each service (private or public) and according to the epidemiological issues COVID19 presents in each area and revised recommendations may arise at any time.
Publication History
Received: 17 April 2020
Accepted: 24 April 2020
Article published online:
08 May 2020
© 2022. This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Gilberto Luiz da Silva Amorim, Daniele Xavier Assad, Bruno Lemos Ferrari, Daniela Dornelles Rosa, Bruno Pacheco Pereira, Renan Orsati Clara, Clarissa Maria de Cerqueira Mathias. Breast oncology and the COVID-19 pandemic: Recommendations from the Brazilian Society of Clinical Oncology (SBOC). Brazilian Journal of Oncology 2020; 16: e-20190024.
DOI: 10.5935/2526-8732.20190024
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REFERENCES
- England N.. COVID-19 rapid guideline: delivery of systemic anticancer treatments: NICE: National Institute for Health and Care Excellence. 2020 Available from: https://www.nice.org.uk/guidance/ng161/resources/covid19-rapidguideline-delivery-of-systemic-anticancertreatments-pdf-66141895710661
- Ueda M, Martins R, Hendrie PC. et al Managing Cancer Care During the COVID- 19 Pandemic: Agility and Collaboration Toward a Common Goal. J Natl Compr Canc Netw 2020; 1-4
- American College of Surgeons: COVID-19: Guidance for Triage of Non-Emergent Surgical Procedures. 2020 Availablefrom: https://www.facs.org/covid-19/clinical-guidance/triage
- Soran A, Brufsky A, Gimbel M. et al Breast Cancer Diagnosis, Treatment and Follow-Up During COVID-19 Pandemic. Eur J Breast Health 2020; 86-88
- American College of Surgeons. Recommendations for Prioritization, Treatment and Triage of Breast Cancer Patients During the COVID-19 Pandemic: Executive Summary. 2020 Availablefrom: https://www.facs.org/qualityprograms/cancer/executive-summary
- Saúde Md.. Protocolo de Manejo Clínico do Coronavírus (COVID-19) na atenção primária à saúde Brazil. 2020 Available from: https://www.saude.gov.br/images/pdf/2020/marco/20/20200318ProtocoloManejo-ver002.pdf
- Coles CE, Aristei C, Bliss J. et al International Guidelines on Radiation Therapy for Breast Cancer During the COVID-19 Pandemic. Clin Oncol 2020; 32: 279-281
-
Lambertini M,
Toss A,
Passaro A.
et al
Cancer care during the spread of coronavirus disease 2019 (COVID-19) in Italy: young oncologists' perspective. . ESMO Open 5(2),2020
- Thomas A, Routh ED, Pullikuth A. et al Tumor mutational burden is a determinant of immune-mediated survival in breast cancer. Oncoimmunology 2018; 7: e1490854
- Cancer Genome Atlas N. Comprehensive molecular portraits of human breast tumours. Nature 2012; 490: 61-70
- Liu S, Chapman J-AW, Burnell MJ. et al Prognostic and predictive investigationof PAM50 intrinsic subtypes in the NCIC CTG MA.21 phase III chemotherapy trial. Breast Cancer Res Treat 2015; 149: 439-448
- Ellis MJ, Suman VJ, Hoog J. et al Randomized phase II neoadjuvant comparisonbetween letrozole, anastrozole, and exemestane for postmenopausal women with estrogen receptor-rich stage 2 to 3 breast cancer: clinical and biomarker outcomes and predictive value of the baseline PAM50-based intrinsic subtype--ACOSOG Z1031. J Clinical Oncol 2011; 29: 2342-2349
- Pease AM, Riba LA, Gruner RA. et al Oncotype DX® Recurrence Score as a Predictor of Response to Neoadjuvant Chemotherapy. Ann Surg Oncol 2019; 26: 366-371
- Tolaney S, Guo H, Pernas S. et al Seven-Year Follow-Up Analysis of Adjuvant Paclitaxel and Trastuzumab Trial for Node-Negative, Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer. Journal of Clinical Oncology 2019; 37: JCO.19.00066
- Tolaney SM, Trippa L, Barry W. et al A randomized phase II study of adjuvant trastuzumab emtansine (T-DM1) vs paclitaxel (T) in combination with trastuzumab (H) for stage I HER2-positive breast cancer (BC) (ATEMPT). Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14. San Antonio, TX: Cancer Res 80: Abstract, 2020
- von Minckwitz G, Huang CS, Mano MS. et al Trastuzumab Emtansine for Residual Invasive HER2-Positive Breast Cancer. New England Journal of Medicine 2019; 380: 617-628
- Oncológica SBdC.. EPIDEMIA DE COVID 19 - PRONUNCIAMENTO SOCIEDADE BRASILEIRA DE CIRURGIA ONCOLÓGICA. 2020
- Ontario OHCC. Pandemic Planning Clinical Guideline for Patients with Cancer. 2020 Available from: https://www.accc-cancer.org/docs/documents/cancer-program-fundamentals/oh-cco-pandemicplanning-clinical-guideline_In_the_case_of_pathological_2020-03-10.pdf?sfvrsn=d2f04347_2