Mathelin Carole, Ame Shanti, Anyanwu Stanley, Avisar Eli, Boubnider Wahib Mohcen, Breitling Katrin, Anie Hannah Ayettey, Conceição José Carlos, Dupont Veronique, Elder Elisabeth, Elfgen Constanze, Elonge Tony, Iglesias Edelmiro, Imoto Shigeru, Ioannidou-Mouzaka Lydia, Kappos Elisabeth A, Kaufmann Martin, Knauer Michael, Luzuy Franck, Margaritoni Marko, Mbodj Mamadou, Mundinger Alexander, Orda Ruben, Ostapenko Valerijus, Özbaş Serdar, Özmen Vahit, Pagani Olivia, Pieńkowski Tadeusz, Schneebaum Schlomo, Shmalts Ekaterina, Selim Ashraf, Pavel Zotov, Lodi Massimo, Maghales-Costa Maurício
Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg Cedex, France.
Immediate the Senology International Society (SIS) Past President, France.
Eur J Breast Health. 2021 Mar 31;17(2):188-196. doi: 10.4274/ejbh.galenos.2021.2021-1-4. eCollection 2021 Apr.
In early 2020, the spread of coronavirus disease-2019 (COVID-19) led the World Health Organization to declare this disease a pandemic. Initial epidemiological data showed that patients with cancer were at high risk of developing severe forms of COVID-19. National scientific societies published recommendations modifying the patients' breast cancer (BC) management to preserve, in theory, quality oncologic care, avoiding the increased risk of contamination. The Senology International Society (SIS) decided to take an inventory of the actions taken worldwide. This study investigates COVID-19-related changes concerning BC management and analyzes the will to maintain them after the pandemic, evaluating their oncological safety consequences.
SIS network members participated in an online survey using a questionnaire (Microsoft Forms) from June 15 to July 31, 2020.
Forty-five responses from 24 countries showed that screening programs had been suspended (68%); magnetic resonance imagines were postponed (73%); telemedicine was preferred when possible (71%). Surgeries were postponed: reconstructive (77%), for benign diseases (84%), and in patients with significant comorbidities (66%). Chemotherapy and radiotherapy protocols had been adapted in 28% of patients in both. Exception for telemedicine (34%), these changes in practice should not be continued.
The SIS survey showed significant changes in BC's diagnosis and treatment during the first wave of the COVID-19 pandemic, but most of these changes should not be maintained. Indeed, women have fewer severe forms of COVID-19 and are less likely to die than men. The risk of dying from COVID-19 is more related to the presence of comorbidities and age than to BC. Stopping screening and delaying treatment leads to more advanced stages of BC. Only women aged over 65 with BC under treatment and comorbidities require adaptation of their cancer management.
2020年初，2019冠状病毒病（COVID-19）的传播致使世界卫生组织宣布该疾病为大流行病。初步流行病学数据显示，癌症患者罹患重症COVID-19的风险很高。各国科学协会发布了相关建议，调整患者的乳腺癌（BC）管理方案，理论上是为了确保优质的肿瘤治疗，避免感染风险增加。国际乳腺病学会（SIS）决定对全球采取的行动进行梳理。本研究调查了与COVID-19相关的BC管理变化，并分析了疫情后维持这些变化的意愿，评估其对肿瘤学安全性的影响。
SIS网络成员于2020年6月15日至7月31日通过问卷（Microsoft Forms）参与了一项在线调查。
来自24个国家的45份回复表明，筛查项目已暂停（68%）；磁共振成像检查被推迟（73%）；尽可能优先选择远程医疗（71%）。手术被推迟：重建手术（77%）、良性疾病手术（84%）以及有严重合并症患者的手术（66%）。化疗和放疗方案在28%的患者中都进行了调整。除远程医疗（34%）外，这些实际中的变化不应继续维持。
SIS的调查显示在COVID-19大流行的第一波期间，BC的诊断和治疗发生了显著变化，但这些变化大多不应继续维持。事实上，女性罹患重症COVID-19的情况少于男性，死亡可能性也更低。死于COVID-19的风险更多地与合并症和年龄有关，而非与BC相关。停止筛查和推迟治疗会导致BC进入更晚期阶段。只有年龄超过65岁、正在接受治疗且患有合并症的BC女性需要调整其癌症管理方案。
