key: cord-309875-8awkpi2p
authors: Cavalcante, Francisco Pimentel; Novita, Guilherme Garcia; Millen, Eduardo Camargo; Zerwes, Felipe Pereira; de Oliveira, Vilmar Marques; Sousa, Ana Luiza Lima; Junior, Ruffo Freitas
title: Breast cancer and COVID‐19 pandemic in Brazil
date: 2020-08-05
journal: J Surg Oncol
DOI: 10.1002/jso.26143
sha: 
doc_id: 309875
cord_uid: 8awkpi2p

nan

After the pandemic outbreak, for reasons well described in this review, many emergency guidelines [2] [3] [4] were developed by experts from around the world. They suggested postponing surgery for invasive EBC, recommending strategies according to molecular subtype. For example, for tumors that express hormone receptors (HR+), the recommendation could be to start treatment with neoadjuvant endocrine therapy (NET) for 3 to 6 months, while in adverse biologic subtypes, such as HER2+ and triple-negative (TN), the recommendation could be to extend the use of neoadjuvant chemotherapy (NACT). In addition, there was a recommendation to avoid the major procedure, such as the use of myocutaneous flaps in breast reconstruction and prophylactic operations. Although some of these suggestions have not been officially endorsed by the Brazilian Society of Mastology (SBM), it is possible that these international guidelines had an impact in Brazil.

To assess this hypothesis, during the months of April and May 2020, an electronic survey was conducted among SBM members regarding the initial management of EBC. We created questions regarding invasive, T1/2 N0 HR+, and T1N0 HER2+/TN cancers, because these patients, in Brazil, are normally submitted to primary surgery. After approval of the SBM's internal review board, the questionnaire was sent to 1462 Brazilian mastologists. The results were submitted to a scientific journal, but we have an online "preprint" publication of the study data. 5 There were 503 responders These findings highlight important changes in the approach of the mastologists at the beginning and during the pandemic, particularly with respect to HR-positive tumors, and reflects, in our opinion, the disagreements between the emergency guidelines described by Garg et al. 1 However, since the data were developed from a survey, we cannot confirm that these recommendations translated into treatment recommendations for actual patients. More studies are needed to know the real impact of the pandemic on patients treated with breast cancer in the pandemic period.

Discordance of COVID-19 guidelines for patients with cancer: a systematic review

A practical approach to the management of cancer patients during the novel coronavirus disease 2019 (COVID-19) pandemic: an international collaborative group

Recommendations for prioritization, treatment, and triage of breast cancer patients during the COVID-19 pandemic. the COVID-19 pandemic breast cancer consortium

Recommendations for triage, prioritization and treatment of breast cancer patients during the COVID-19 pandemic

Management of early breast cancer during the COVID-19 pandemic in Brazil

The authors declare that there are no conflict of interests.