Management of breast cancer patients during the peak of the COVID 19 pandemic
Ce dossier présente un ensemble d'articles concernant la prise en charge des cancers durant la crise sanitaire liée au COVID-19
During COVID 19 pandemic several recommendations were published which modified the standard guidelines advising a reduction in the use of chemotherapy, biological agents, and surgery in the treatment of breast cancer patients. We analyzed how the senology program of the European Institute of Oncology, (IEO) in Milan, organized its activities during the peak of the pandemic (March–April 2020). We compared this data with that of the same period last year (March–April 2019) to evaluate the impact of the COVID 19 infection on the management of breast cancer patients. Categorical variables were reported as frequencies (percentages) and percentage differences between 2020 and 2019 were also provided. Differences between 2019 and 2020 were evaluated with Chi-squared test or with Fisher exact test. During March–April 2020 a total of 562 patients underwent surgery for breast cancer compared to 526 of the same period in the previous year. The number of patients from Lombardy was 244 compared to 155 in the same period in 2019. Of the 562 patients, 57 came from other hospitals in the region, which had been converted to COVID hospitals. Regarding the disease stage, a significantly higher percentage (90.6% vs 86%, P = 0.05) of invasive tumors were treated, as compared with previous years. Significant differences were observed also for reason of admission (P < 0.01): those admitted to surgery without a previous history of diagnosis increased (82% in 2020 and 79% in 2019) and a limited number of patients received contralateral prophylactic breast surgery (0.4% in 2020 vs 1.3% in 2019, P < 0.01). Furthermore, compared to previous year, more patients underwent to nipple-sparing mastectomy followed by immediate breast reconstruction with implant or tissue expander (152 vs 130). The most frequent molecular subtype was luminal B - HER2 negative disease (43% of invasive breast cancer in 2020 vs 41% in 2019), but the difference was not statistically significant (P = 0.42).
European Journal of Surgical Oncology , article en libre accès, 2020