Group for Reconstructive and Therapeutic Advancements (G.Re.T.A.), Milan, Naples, Catania, Italy.
Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Oncologist. 2021 Jan;26(1):e66-e77. doi: 10.1002/onco.13560. Epub 2020 Nov 25.
The rapid spread of COVID-19 across the globe is forcing surgical oncologists to change their daily practice. We sought to evaluate how breast surgeons are adapting their surgical activity to limit viral spread and spare hospital resources.
A panel of 12 breast surgeons from the most affected regions of the world convened a virtual meeting on April 7, 2020, to discuss the changes in their local surgical practice during the COVID-19 pandemic. Similarly, a Web-based poll based was created to evaluate changes in surgical practice among breast surgeons from several countries.
The virtual meeting showed that distinct countries and regions were experiencing different phases of the pandemic. Surgical priority was given to patients with aggressive disease not candidate for primary systemic therapy, those with progressive disease under neoadjuvant systemic therapy, and patients who have finished neoadjuvant therapy. One hundred breast surgeons filled out the poll. The trend showed reductions in operating room schedules, indications for surgery, and consultations, with an increasingly restrictive approach to elective surgery with worsening of the pandemic.
The COVID-19 emergency should not compromise treatment of a potentially lethal disease such as breast cancer. Our results reveal that physicians are instinctively reluctant to abandon conventional standards of care when possible. However, as the situation deteriorates, alternative strategies of de-escalation are being adopted.
This study aimed to characterize how the COVID-19 pandemic is affecting breast cancer surgery and which strategies are being adopted to cope with the situation.
COVID-19 在全球范围内的迅速传播迫使外科肿瘤学家改变他们的日常实践。我们试图评估乳腺外科医生如何调整他们的手术活动，以限制病毒传播并节省医院资源。
2020 年 4 月 7 日，来自世界上受影响最严重地区的 12 名乳腺外科医生组成的小组召开了一次虚拟会议，讨论在 COVID-19 大流行期间他们当地手术实践的变化。同样，创建了一个基于网络的调查，以评估来自多个国家的乳腺外科医生手术实践的变化。
虚拟会议表明，不同的国家和地区正在经历大流行的不同阶段。手术重点放在没有接受主要系统治疗的侵袭性疾病患者、接受新辅助系统治疗的进展性疾病患者和已完成新辅助治疗的患者身上。100 名乳腺外科医生填写了问卷。趋势表明手术室计划、手术指征和咨询减少，随着大流行的恶化，对择期手术的限制越来越严格。
COVID-19 紧急情况不应影响对乳腺癌等潜在致命疾病的治疗。我们的结果表明，医生本能地不愿意在可能的情况下放弃常规护理标准。然而，随着情况的恶化，正在采取替代的降级策略。
本研究旨在描述 COVID-19 大流行如何影响乳腺癌手术，以及正在采取哪些策略来应对这种情况。
