Consortium Offers Breast Cancer Treatment Recommendations During COVID-19 Pandemic
Posted: Thursday, April 23, 2020
An unprecedented challenge oncologists are facing during the COVID-19 pandemic is how to effectively triage treatment for patients with breast cancer. Representatives from the American Society of Breast Surgeons, the National Accreditation Program for Breast Cancers, the Commission on Cancer of the American College of Surgeons (ACS), the American College of Radiology, and the National Comprehensive Cancer Network collaborated to offer guidance for this patient population. Featured in these recommendations is a multidisciplinary approach to prioritizing treatment for patients requiring urgent care versus those who can delay treatment. However, they warned, these recommendations are only for patients with breast cancer who are not suspected to have the coronavirus.
“These guidelines can help modify patient care to minimize exposure risk and preserve resources for patients with the most immediate need for care,” stated Lawrence N. Shulman, MD, Chair of the Commission on Cancer, in an ACS press release.
Patients with breast cancer should be sorted into three “priority” categories based on the severity of their illness. Patients ranked as Priority A have life-threatening and clinically unstable conditions for which delaying treatment could jeopardize their health. These patients have the highest need for immediate treatment, even if resources become limited. In addition, this category of patients is recommended to be seen in person.
Patients ranked as Priority B, such as those who have estrogen receptor–positive, HER2-negative tumors, can delay surgery for 6 to 12 weeks and receive neoadjuvant endocrine surgery as an alternative treatment. However, they will need to resume their primary treatment when the pandemic is over or if there is a delay of longer than 12 weeks. Depending on the need, this category of patients can be seen in person or through telemedicine.
Patients designed as Priority C, such as those coming in for routine or survivorship visits, have stable conditions and can delay treatment until the end of the pandemic without risking adverse effects. These patients are recommended to be treated solely through telemedicine.
Disclosure: The study authors reported no conflicts of interest.
