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Dietz JR , Moran MS , Isakoff SJ , Kurtzman SH , Willey SC , Burstein HJ , Bleicher RJ , Lyons JA , Sarantou T , Baron PL , Stevens RE , Boolbol SK , Anderson BO , Shulman LN , Gradishar WJ , Monticciolo DL , Plecha DM , Nelson H , Yao KA
Recommendations for prioritization, treatment, and triage of breast cancer patients during the COVID-19 pandemic. the COVID-19 pandemic breast cancer consortium
Breast Cancer Res Treat. 2020 Jun;181(3) :487-497
PMID: 32333293 PMCID: PMC7181102 URL: https://www.ncbi.nlm.nih.gov/pubmed/32333293
AbstractThe 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.
NotesDietz, Jill R Moran, Meena S Isakoff, Steven J Kurtzman, Scott H Willey, Shawna C Burstein, Harold J Bleicher, Richard J Lyons, Janice A Sarantou, Terry Baron, Paul L Stevens, Randy E Boolbol, Susan K Anderson, Benjamin O Shulman, Lawrence N Gradishar, William J Monticciolo, Debra L Plecha, Donna M Nelson, Heidi Yao, Katharine A eng Editorial Netherlands Breast Cancer Res Treat. 2020 Jun;181(3):487-497. doi: 10.1007/s10549-020-05644-z. Epub 2020 Apr 24.