Breast cancer management pathways during the COVID-19 pandemic: outcomes from the UK ‘Alert Level 4’ phase of the B-MaP-C study

Autor: Jamie J Kirkham, Ellen Copson, Baek Kim, Shelley Potter, Charlotte E. Coles, Nisha Sharma, Elizabeth Camacho, Kieran Horgan, Stuart McIntosh, Daniel R. Leff, Rachel O'Connell, Rajiv V. Dave, Chris Holcombe, Ramsey I. Cutress, Patricia Fairbrother, Christopher W. J. Cartlidge, Ashu Gandhi, Vicky P. Taxiarchi, Alona Courtney, Tim Rattay, Raghavan Vidya, Cliona C. Kirwan
Přispěvatelé: Dave, Rajiv V. [0000-0001-6827-8090], McIntosh, Stuart A. [0000-0002-4123-9611], Potter, Shelley [0000-0002-6977-312X], Copson, Ellen [0000-0001-8994-4056], Apollo - University of Cambridge Repository, Cancer Research UK, Dave, Rajiv V [0000-0001-6827-8090], McIntosh, Stuart A [0000-0002-4123-9611]
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Cancer Research
692/700/784
medicine.medical_treatment
Cohort Studies
0302 clinical medicine
Breast cancer
Quality of life
Surgical oncology
Pandemic
Epidemiology
030212 general & internal medicine
692/700/1538
Aged
80 and over
Covid19
health policy
Middle Aged
Health care economics
Health policy
Oncology
030220 oncology & carcinogenesis
Practice Guidelines as Topic
Female
Breast reconstruction
Life Sciences & Biomedicine
B-MaP-C study collaborative
Cohort study
Adult
medicine.medical_specialty
Breast Neoplasms
Article
1117 Public Health and Health Services
692/4028/546
surgical oncology
03 medical and health sciences
breast cancer
SDG 3 - Good Health and Well-being
medicine
Humans
1112 Oncology and Carcinogenesis
692/700/3934
Oncology & Carcinogenesis
Aged
Science & Technology
business.industry
SARS-CoV-2
COVID-19
health care economics
medicine.disease
Radiation therapy
quality of life
Emergency medicine
692/4028/67/1347
business
Zdroj: British Journal of Cancer
Dave, R V, Kim, B, Courtney, A, O'Connell, R L, Rattay, T, Taxiarchi, V, Kirkham, J J, Camacho, E, Fairbrother, P, Sharma, N, Cartlidge, C W J, Horgan, K, McIntosh, S A, Leff, D R, Vidya, R, Potter, S, Holcombe, C, Copson, E, Coles, C, Cutress, R I, Gandhi, A & Kirwan, C 2021, ' Breast cancer management pathways during the COVID-19 pandemic: outcomes from the UK ‘Alert Level 4’ phase of the B-MaP-C study ', British Journal of Cancer . https://doi.org/10.1038/s41416-020-01234-4
Dave, R V, Potter, S, Kirwan, C C, Fairhurst, K J, al., E 2021, ' Breast Cancer Management Pathways during the COVID-19 pandemic : Outcomes from the UK ‘Alert Level 4’ phase of the B-MaP-C study ', British Journal of Cancer, vol. 124, no. 11, pp. 1785-1794 . https://doi.org/10.1038/s41416-020-01234-4
ISSN: 1532-1827
0007-0920
Popis: Background The B-MaP-C study aimed to determine alterations to breast cancer (BC) management during the peak transmission period of the UK COVID-19 pandemic and the potential impact of these treatment decisions. Methods This was a national cohort study of patients with early BC undergoing multidisciplinary team (MDT)-guided treatment recommendations during the pandemic, designated ‘standard’ or ‘COVID-altered’, in the preoperative, operative and post-operative setting. Findings Of 3776 patients (from 64 UK units) in the study, 2246 (59%) had ‘COVID-altered’ management. ‘Bridging’ endocrine therapy was used (n = 951) where theatre capacity was reduced. There was increasing access to COVID-19 low-risk theatres during the study period (59%). In line with national guidance, immediate breast reconstruction was avoided (n = 299). Where adjuvant chemotherapy was omitted (n = 81), the median benefit was only 3% (IQR 2–9%) using ‘NHS Predict’. There was the rapid adoption of new evidence-based hypofractionated radiotherapy (n = 781, from 46 units). Only 14 patients (1%) tested positive for SARS-CoV-2 during their treatment journey. Conclusions The majority of ‘COVID-altered’ management decisions were largely in line with pre-COVID evidence-based guidelines, implying that breast cancer survival outcomes are unlikely to be negatively impacted by the pandemic. However, in this study, the potential impact of delays to BC presentation or diagnosis remains unknown.
Databáze: OpenAIRE
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