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Breast ; 55: 1-6, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-969026


INTRODUCTION: In order to minimise the risk of breast cancer patients for COVID-19 infection related morbidity and mortality prioritisation of care has utmost importance since the onset of the pandemic. However, COVID-19 related risk in patients undergoing breast cancer surgery has not been studied yet. We evaluated the safety of breast cancer surgery during COVID-19 pandemic in the West of Scotland region. METHODS: A prospective cohort study of patients having breast cancer surgery was carried out in a geographical region during the first eight weeks of the hospital lockdown and outcomes were compared to the regional cancer registry data of pre-COVID-19 patients of the same units (n = 1415). RESULTS: 188 operations were carried out in 179 patients. Tumour size was significantly larger in patients undergoing surgery during hospital lockdown than before (cT3-4: 16.8% vs. 7.4%; p < 0.001; pT2 - pT4: 45.5% vs. 35.6%; p = 0.002). ER negative and HER-2 positive rate was significantly higher during lockdown (ER negative: 41.3% vs. 17%, p < 0.001; HER-2 positive: 23.4% vs. 14.8%; p = 0.004). While breast conservation rate was lower during lockdown (58.6% vs. 65%; p < 0.001), level II oncoplastic conservation was significantly higher in order to reduce mastectomy rate (22.8% vs. 5.6%; p < 0.001). No immediate reconstruction was offered during lockdown. 51.2% had co-morbidity, and 7.8% developed postoperative complications in lockdown. There was no peri-operative COVID-19 infection related morbidity or mortality. CONCLUSION: breast cancer can be safely provided during COVID-19 pandemic in selected patients.

Breast Neoplasms/surgery , COVID-19/epidemiology , Cross Infection/epidemiology , Mastectomy/methods , Postoperative Complications/epidemiology , Adult , Aged , Aged, 80 and over , Breast Carcinoma In Situ/pathology , Breast Carcinoma In Situ/surgery , Breast Neoplasms/pathology , Carcinoma, Ductal, Breast/pathology , Carcinoma, Ductal, Breast/surgery , Carcinoma, Intraductal, Noninfiltrating/pathology , Carcinoma, Intraductal, Noninfiltrating/surgery , Carcinoma, Lobular/pathology , Carcinoma, Lobular/surgery , Cohort Studies , Female , Humans , Male , Mastectomy/statistics & numerical data , Mastectomy, Segmental/methods , Mastectomy, Segmental/statistics & numerical data , Middle Aged , Neoplasm Staging , Prospective Studies , SARS-CoV-2 , Scotland/epidemiology , State Medicine , Tumor Burden
In Vivo ; 34(3 Suppl): 1667-1673, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-527842


BACKGROUND: COVID-19 pandemic required a marked re-allocation of healthcare resources, including at Breast Units. A patient-tailored program was developed to assess its efficacy regarding prevention of COVID-19 infection among patients with breast cancer undergoing surgery and healthcare workers (HCWs). PATIENTS AND METHODS: From March 9th to April 9th 2020, 91 patients were selected for elective surgery by means of: i) Pre-hospital screening aimed at avoiding hospitalization of symptomatic or suspicious COVID-19 patients, and ii) prioritisation of surgical procedure according to specific disease features. RESULTS: Eighty-five patients (93.4%) were fit for surgery, while five patients (5.5%) were temporarily excluded through 'telephone triage'; another two patients were excluded at in-hospital triage. A total of 71 out of 85 patients (83.5%) were diagnosed with invasive cancer, most of whom were undergoing breast-conserving surgery (61 out of 85 patients, 71.8%). The mean in-hospital stay was 2.2 days (SD=0.7 days). After hospital discharge, no patient needed re-admission due to post-operative complications; moreover, no COVID-19 infection among patients or HCWs was detected. CONCLUSION: Safe breast cancer surgery was accomplished for both patients and HCWs by means of a careful preoperative selection of patients and in-hospital preventative measures. This screening program can be transferred to high-volume Breast Units and it may be useful in implementing European Community recommendations for prevention of COVID-19 infection.

Breast Neoplasms/surgery , Carcinoma/surgery , Coronavirus Infections/prevention & control , Elective Surgical Procedures/statistics & numerical data , Infection Control/methods , Mastectomy/statistics & numerical data , Pandemics/prevention & control , Patient Selection , Pneumonia, Viral/prevention & control , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Breast Neoplasms/drug therapy , Breast Neoplasms/epidemiology , Breast Neoplasms/nursing , COVID-19 , COVID-19 Testing , Carcinoma/drug therapy , Carcinoma/epidemiology , Carcinoma/nursing , Clinical Laboratory Techniques , Combined Modality Therapy , Coronavirus Infections/diagnosis , Female , Hospital Units/organization & administration , Humans , Italy/epidemiology , Length of Stay/statistics & numerical data , Lymphatic Metastasis/diagnostic imaging , Lymphoscintigraphy , Mastectomy, Segmental/statistics & numerical data , Neoadjuvant Therapy , Patient Discharge , Protective Devices , Sentinel Lymph Node Biopsy , Symptom Assessment , Telemedicine , Triage