ABSTRACT
Goals: COVD-19 global pandemic has seriously affected many health systems around the world, particularly in countries extremely hit remarkably such as Italy, Spain and the UK. As a response, hospitals had to reduce access to elective patients to avoid the spread of infectious disease, and many international societies and groups of experts have published clinical guidelines and recommendations about surgical management of breast cancer patients in this time of crisis and Issued COVID guidelines to prioritize surgery for whom time is critical and cannot be deferred. Methods:We performed a comprehensive review from November 1, 2019 to October 25, 2020 of the published literature in English language on COVID-19. Keywords used were: Coronavirus, COVID-19, nCoV, Breast Cancer, Corona crisis, Breast Surgery. Studies were included if they fulfilled specific eligibility criteria such as combination of keywords to focus the subject of COVID-19 and breast surgery. Non-scientific commentary, reports, and news articleswere excluded from the analysis. Results: Among the 118 research articles included in the analysis, 9 articles were included. Based on the review and experts opinions;therewere strong supportive arguments to support providing surgery in breast cancer services, therefore we proposed a strategy to be implemented to resume and to keep providing breast cancer surgery during the pandemic: Provide a one stop triple assessment clinic for patients with a high suspicion of cancer, agreed MDT treatment decisions, provide a single pre-op consultation, perform Breast surgery under day case setup, offer routine wider margin excision where feasible, oncoplastic and reconstructive breast surgery in carefully selected patient, single post op results consultation with follow up phone/Teleconsultation as needed, regular locoregional guidelines review, surgery prioritizing to be escalated or de-escalated according to the level of pandemic with regular revision of pooled waiting lists. Conclusion(s): COVID-19 may live with us for many months and years, we still face the uncertainty to the course of the pandemic and the challenges of the future waves with a considerable concern over the impact on cancer patients, Including accumulated untreated cases. To avoid such additional impact and deaths from breast cancer, new protocols under new norms to are of paramount importance to continue to deliver breast cancer surgery safely. Conflict of Interest: No significant relationships.