Published time: 24 April 2020
Authors: Jill R. Dietz, Meena S. Moran, Steven J. Isakoff, Scott H. Kurtzman, Shawna C. Willey, Harold J. Burstein, Richard J. Bleicher, Janice A. Lyons, Terry Sarantou, Paul L. Baron, Randy E. Stevens, Susan K. Boolbol, Benjamin O. Anderson, Lawrence N. Shulman, William J. Gradishar, Debra L. Monticciolo, Donna M. Plecha, Heidi Nelson & Katharine A. Yao.
Keywords: Covid-19, pandemic, breast cancer, prioritization.
The COVID-19 pandemic presents clinicians a unique set of challenges in managing breast cancer (BC) patients. As hospital resources and staff become more limited during the COVID-19 pandemic, it becomes critically important to define which BC patients require more urgent care and which patients can wait for treatment until the pandemic is over. In this Special Communication, we use expert opinion of representatives from multiple cancer care organizations to categorize BC patients into priority levels (A, B, C) for urgency of care across all specialties. Additionally, we provide treatment recommendations for each of these patient scenarios. Priority A patients have conditions that are immediately life threatening or symptomatic requiring urgent treatment. Priority B patients have conditions that do not require immediate treatment but should start treatment before the pandemic is over. Priority C patients have conditions that can be safely deferred until the pandemic is over. 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. 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 (virus associated with the COVID-19 pandemic). Physicians should use these recommendations to prioritize care for their BC patients and adapt treatment recommendations to the local context at their hospital.
Recommendations for prioritization, treatment, and triage of breast cancer patients during the COVID-19 pandemic. the COVID-19 pandemic breast cancer consortium