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Neoadjuvant endocrine therapy use in early stage breast cancer during the covid-19 pandemic.
Park, Ko Un; Gregory, Megan; Bazan, Joey; Lustberg, Maryam; Rosenberg, Shoshana; Blinder, Victoria; Sharma, Priyanka; Pusztai, Lajos; Shen, Chengli; Partridge, Ann; Thompson, Alastair.
  • Park KU; Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center James Comprehensive Cancer Center, Columbus, OH, USA. Koun.park@ousmc.edu.
  • Gregory M; The Ohio State University Wexner Medical Center, 410 W 10th Ave, N908 Doan Hall, Columbus, OH, 43210, USA. Koun.park@ousmc.edu.
  • Bazan J; Department of Biomedical Informatics, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
  • Lustberg M; Department of Radiation Oncology, The Ohio State University Wexner Medical Center James Comprehensive Cancer Center, Columbus, OH, USA.
  • Rosenberg S; Division of Medical Oncology, Department of Medicine, The Ohio State University Wexner Medical Center James Comprehensive Cancer Center, Columbus, OH, USA.
  • Blinder V; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
  • Sharma P; Memorial Sloan Kettering Cancer Center, New York, NY, USA.
  • Pusztai L; Division of Medical Oncology, Department of Medicine, University of Kansas Medical Center, Westwood, KS, USA.
  • Shen C; Section of Medical Oncology, Department of Medicine, Yale University, New Haven, CT, USA.
  • Partridge A; Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center James Comprehensive Cancer Center, Columbus, OH, USA.
  • Thompson A; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
Breast Cancer Res Treat ; 188(1): 249-258, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1111289
ABSTRACT

PURPOSE:

Physician treatment preferences for early stage, estrogen positive breast cancer (ER + BC) patients were evaluated during the initial surge of the COVID-19 pandemic in the US when neoadjuvant endocrine therapy (NET) was recommended to allow safe deferral of surgery.

METHODS:

A validated electronic survey was administered May-June, 2020 to US medical oncologists (MO), radiation oncologists (RO), and surgeons (SO) involved in clinical trials organizations. Questions on NET use included practice patterns for locoregional management following NET.

RESULTS:

114 Physicians from 29 states completed the survey-42 (37%) MO, 14 (12%) RO, and 58 (51%) SO. Before COVID-19, most used NET 'rarely' (49/107, 46%) or 'sometimes' (36, 33%) for ER + BC. 46% would delay surgery 2 months without NET. The preferred NET regimen was tamoxifen for premenopausal and aromatase inhibitor for postmenopausal women. 53% planned short term NET until surgery could proceed. Most recommended omitting axillary lymph node dissection (ALND) for one micrometastatic node after 1, 2, or 3 months of NET (1 month, N = 56/93, 60%; 2 months, N = 54/92, 59%; 3 months, N = 48/90, 53%). With longer duration of NET, omission of ALND decreased, regardless of years in practice, percent of practice in BC, practice type, participation in multidisciplinary tumor board, or number of regional COVID-19 cases.

CONCLUSION:

More physicians preferred NET for ER + BC during the pandemic, compared with pre-pandemic times. As the duration of NET extended, more providers favored ALND in low volume metastatic axillary disease. The Covid-19 pandemic affected practice of ER + BC; it remains to be seen how this may impact outcomes.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Breast Neoplasms / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Limits: Female / Humans Language: English Journal: Breast Cancer Res Treat Year: 2021 Document Type: Article Affiliation country: S10549-021-06153-3

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Breast Neoplasms / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Limits: Female / Humans Language: English Journal: Breast Cancer Res Treat Year: 2021 Document Type: Article Affiliation country: S10549-021-06153-3