New ESMO recommendations for breast cancer care during the COVID-19 era

  • de Azambuja E & al.
  • ESMO Open
  • 01.05.2020

  • von Miriam Davis, PhD
  • Studien – kurz & knapp
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Takeaway

  • The European Society for Medical Oncology (ESMO) has published new recommendations for breast cancer diagnosis and treatment across all phases of care during the COVID-19 era.
  • Hospital visits should be minimized and breast cancer care should be prioritized in high, medium, and low tiers.

Why this matters

  • The authors assert that breast cancer care must be "adapt[ed] during the COVID-19 pandemic using a value-based framework to set priorities" in an effort to prevent COVID-19 infection.

Study design

  • Expert panel review using consensus recommendations.
  • Funding: None.

Highlights

  • Each phase of diagnosis and treatment is assigned priority as high (life-threatening, clinically unstable), medium (noncritical but delay >6-8 weeks could affect outcomes), or low (stable condition allowing for delay of care or minimal benefit of intervention).
  • High-priority scenarios include:
    • Diagnosis of breast lump.
    • Breast cancer surgery complication.
    • Adjuvant postoperative radiation therapy for high-risk patients (triple-negative breast cancer [TNBC] or HER2-positive breast cancer).
    • Surgery for patients who have completed neoadjuvant chemotherapy.
    • Neoadjuvant and adjuvant chemotherapy for TNBC, HER2-positive, and high-risk estrogen receptor-positive breast cancer.
    • Treatment of metastatic disease.
  • Medium priority:
    • Treatment of stage I breast cancer.
    • Surgical delay for low-risk primary breast cancer.
    • Patients with low-risk genomic scores.
  • Low priority:
    • Bone agents therapy for hypercalcemia.
    • Surgery for nonhigh-grade ductal carcinoma in situ.