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Infectious Diseases

Updated 23 April 2020

US breast cancer group issues treatment guidelines for coronavirus pandemic

As hospital resources and staff become limited, it is vital to define which breast cancer patients require urgent care and which can have delayed or alternative treatment.

Guidelines for the prioritisation and treatment of breast cancer patients during the coronavirus pandemic have been released by a group of US medical organisations.

"As hospital resources and staff become limited, it is vital to define which breast cancer patients require urgent care and which can have delayed or alternative treatment without changing survival or risking exposure to the virus," Dr Jill Dietz, president of the American Society of Breast Surgeons, said in a society news release.

And according to Dr Lawrence Shulman, chair of the Commission on Cancer of the American College of Surgeons, "The Covid-19 pandemic presents unprecedented challenges. These guidelines can help modify patient care to minimise exposure risk and preserve resources for patients with the most immediate need for care."

The other groups involved in the release of the new joint recommendations are: the National Accreditation Program for Breast Centers (NAPBC), the National Comprehensive Cancer Network (NCCN), and the American College of Radiology (ACR).

Highest level of available evidence

The recommendations group breast cancer patients into priority levels (A, B, C) for urgency of care, and provide treatment recommendations for each category.

Priority A patients have conditions that are immediately life-threatening or symptomatic and require urgent treatment.

Priority B patients have conditions that do not require immediate treatment, but they should start treatment before the end of the pandemic.

Priority C patients have conditions for which treatment can be safely put on hold until the end of the pandemic.

The recommendations will be published in an upcoming issue of the journal Breast Cancer Research and Treatment.

Weighing the risks

Dr Scott Kurtzman, chair of the NAPBC, said in the news release that "implementation of these recommendations, based on the highest level of available evidence, must be adapted to current resource availability and Covid-19 pandemic severity in that region."

And Dr Debra Monticciolo, president of the ACR, said, "The risk of disease progression and worse patient outcomes should be weighed against risk of patient and staff exposure to the virus."

The chair of the NCCN breast cancer panel, Dr William Gradishar, added that "doctors should use the recommendations to prioritise care for these patients and adapt treatment recommendations to the local context at their hospital."

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