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