Medical Groups Release Recommendations for Breast Cancer Care During COVID-19 Pandemic

A number of expert medical societies developed new joint recommendations for the prioritization, treatment and triage of patients with breast cancer during the coronavirus disease 2019 (COVID-19) pandemic, according to paper published in Breast Cancer Research and Treatment.¹

The American Society of Breast Surgeons (ASBrS), the National Accreditation Program for Breast Centers (NAPBC), the National Comprehensive Cancer Network (NCCN), the Commission on Cancer (CoC) of the American College of Surgeons, and the American College of Radiology (ACR) combined to create these recommendations to help determine which patients need urgent care, and which patients can safely have treatment delayed to help hospitals accommodate COVID-19 patients.²

“The implementation of these recommendations for patient triage, which are based on the highest level available evidence, must be adapted to current availability of hospital resources and severity of the COVID-19 pandemic in each region of the country,” wrote the researchers. “Additionally, the risk of disease progression and worse outcomes for patients need to be weighed against the risk of patient and staff exposure to SARS CoV-2.”

The expert group categorized patients into 3 priority level groups (A, B, C) ordered by urgency of their treatment care across all specialties. Patients in the priority A group have conditions that are “immediately life-threatening or symptomatic, requiring urgent treatment.”

Priority B patients have conditions that do not require immediate treatment, but these patients should start their treatment before the pandemic is over. Patients in the priority C group have conditions that allow them to wait until the pandemic is over to begin treatment.

More, the researchers determined that a majority of outpatient visits should be conducted via telemedicine, as the risk of viral transmission needs to be weighed with an in-person visit. Even further, whenever possible, selectively deferring surgery to limit the use of operating room resources is recommended whenever possible.

“The medical oncology goals are to minimize patient interactions with healthcare centers, maintain patient safety, and conserve resources while providing effective care,” wrote the researchers. “All specialty and institutional goals and patient factors should be considered when formulating a treatment plan.”

With these recommendations, leading medical experts agree that the need to limit treatment when possible is the best way to not only limit exposure to potential viral transmissions, but also maximize the resources available to treat patients suffering from symptoms of COVID-19.

The researchers continued that this information should be used to organize a “process of structured decision-making” to care for patients of breast cancer throughout the COVID-19 pandemic. Even with these guidelines in place, the experts understand that as the pandemic evolves, so should these guidelines to ensure the best practices and recommendations are in place given the pandemic’s standing.

“Physicians should use these recommendations to prioritize care for their BC patients and adapt treatment recommendations to the local context at their hospital,” wrote the researchers.

References:

1. Dietz JR, Moran MS, Isakoff SJ, et al. Recommendations for Prioritization, Treatment and Triage of Breast Cancer Patients During the COVID-19 Pandemic. Breast Cancer Research and Treatment.

2. Expert Medical Societies Release Multidisciplinary Recommendations for Breast Cancer Patient Care During COVID-19 Pandemic [news release]. Washington DC. Published April 13, 2020. https://www.facs.org/media/press-releases/2020/covid-breast-cancer041320?utm_source=miragenews&utm_medium=miragenews&utm_campaign=news. Accessed April 15, 2020.