Vohra Lubna M, Jabeen Dua, Asif Narmeen, Ahad Abdul
Department of Breast Surgery, Aga Khan University Hospital, Karachi, Pakistan.
Jinnah Sindh Medical University, Rafiqi H.J, Iqbal Shaheed Rd, Karachi Cantonment, Karachi, 75510, Pakistan.
Ann Med Surg (Lond). 2021 Mar;63:102151. doi: 10.1016/j.amsu.2021.01.099. Epub 2021 Feb 4.
COVID-19 outbreak has adversely affected care of breast cancer patients world-wide. There is paucity of available data on cancer management in lower-middle income countries during this pandemic, we sought to determine the institutional approach towards management of breast cancer patients and the outcomes during COVID-19 pandemic at our institution.
Clinicopathological and treatment record of cancer patients who presented to the Breast Clinic from 15th March to 31 December 2020 was retrieved from the institutional database for this retrospective clinical observational study.
A total of 292 patients were qualified for the analysis in which 206 patients (70.5%) underwent breast cancer surgeries. Only 10 of them (4.9%) were identified to be COVID-19 virus positive on routine pre-operative RT-PCR test before elective surgeries. All were asymptomatic, received home-based care via telecommunication and were operated at a later date when test turned out negative. None of them developed any complications post-operatively. Another group of 86 patients (29.5%) were referred for Neoadjuvant/Systemic chemotherapy in which COVID-19 infection was detected in only 4 patients (4.6%) while receiving cycles. Two patients shown symptoms of cough and fever hence hospitalised but were not candidates for Intensive Care Unit admission while other two patient were asymptomatic and isolated at home. All patients recovered well and chemotherapy was commenced again after negative RT-PCR test. No mortality was observed.
Despite of being a global crisis particularly for cancer patients we observed infectivity, complications and fatality much lower among breast cancer cases. Further research is needed in this regard including public and private sector hospitals for better understanding behavior of COVID-19 disease and achieve common goal to combat COVID-19 and cancer together.
新型冠状病毒肺炎（COVID-19）疫情对全球乳腺癌患者的治疗产生了不利影响。在这场大流行期间，中低收入国家癌症管理方面的可用数据匮乏，我们试图确定本院在COVID-19大流行期间对乳腺癌患者的管理方法及治疗结果。
从机构数据库中检索2020年3月15日至12月31日到乳腺科就诊的癌症患者的临床病理和治疗记录，用于这项回顾性临床观察研究。
共有292例患者符合分析条件，其中206例（70.5%）接受了乳腺癌手术。在择期手术前的常规术前逆转录聚合酶链反应（RT-PCR）检测中，只有10例（4.9%）被确定为COVID-19病毒阳性。所有患者均无症状，通过远程通信接受居家护理，并在检测结果转为阴性后的较晚日期接受手术。术后他们均未出现任何并发症。另一组86例患者（29.5%）被转诊接受新辅助/全身化疗，其中只有4例（4.6%）在接受化疗周期时检测出COVID-19感染。2例患者出现咳嗽和发热症状，因此住院，但不符合重症监护病房收治标准，而另外2例患者无症状，居家隔离。所有患者恢复良好，RT-PCR检测结果为阴性后再次开始化疗。未观察到死亡病例。
尽管这是一场全球性危机，对癌症患者而言尤甚，但我们观察到乳腺癌病例中的感染率、并发症和死亡率要低得多。在这方面需要进一步开展研究，包括公立和私立医院，以更好地了解COVID-19疾病的表现，并共同实现抗击COVID-19和癌症的共同目标。
