A prospective cohort study of the safety of breast cancer surgery during COVID-19 pandemic in the West of Scotland

• Published in: Breast (Edinburgh) Vol. 55; pp. 1 - 6
• Main Authors: Romics, Laszlo, Doughty, Julie, Stallard, Sheila, Mansell, James, Blackhall, Vivienne, Lannigan, Alison, Elgammal, Suzanne, Reid, Judith, McGuigan, Marie-Claire, Savioli, Francesca, Tovey, Sian, Murphy, Dermott, Reid, Iona, Malyon, Andy, McIlhenny, Jennifer, Wilson, Christopher
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.02.2021; Elsevier
• Subjects: Adult; Aged; Aged, 80 and over; Breast cancer; Breast Carcinoma In Situ - pathology; Breast Carcinoma In Situ - surgery; Breast conservation therapy; Breast Neoplasms - pathology; Breast Neoplasms - surgery; Breast surgery; Carcinoma, Ductal, Breast - pathology; Carcinoma, Ductal, Breast - surgery; Carcinoma, Intraductal, Noninfiltrating - pathology; Carcinoma, Intraductal, Noninfiltrating - surgery; Carcinoma, Lobular - pathology; Carcinoma, Lobular - surgery; Cohort Studies; COVID-19; COVID-19 - epidemiology; Cross Infection - epidemiology; Female; Humans; Male; Mammaplasty; Mastectomy - methods; Mastectomy - statistics & numerical data; Mastectomy, Segmental - methods; Mastectomy, Segmental - statistics & numerical data; Middle Aged; Neoplasm Staging; Original; Pandemics; Postoperative Complications - epidemiology; Prospective Studies; SARS-CoV-2; Scotland - epidemiology; State Medicine; Tumor Burden; Scotland; Breast conservation therapy; COVID-19; Breast cancer; Pandemics; Mammaplasty; Breast surgery
• ISSN: 0960-9776; 1532-3080; 1532-3080
• DOI: 10.1016/j.breast.2020.11.015

In order to minimise the risk of breast cancer patients for COVID-19 infection related morbidity and mortality prioritisation of care has utmost importance since the onset of the pandemic. However, COVID-19 related risk in patients undergoing breast cancer surgery has not been studied yet. We evaluated the safety of breast cancer surgery during COVID-19 pandemic in the West of Scotland region. A prospective cohort study of patients having breast cancer surgery was carried out in a geographical region during the first eight weeks of the hospital lockdown and outcomes were compared to the regional cancer registry data of pre-COVID-19 patients of the same units (n = 1415). 188 operations were carried out in 179 patients. Tumour size was significantly larger in patients undergoing surgery during hospital lockdown than before (cT3-4: 16.8% vs. 7.4%; p < 0.001; pT2 – pT4: 45.5% vs. 35.6%; p = 0.002). ER negative and HER-2 positive rate was significantly higher during lockdown (ER negative: 41.3% vs. 17%, p < 0.001; HER-2 positive: 23.4% vs. 14.8%; p = 0.004). While breast conservation rate was lower during lockdown (58.6% vs. 65%; p < 0.001), level II oncoplastic conservation was significantly higher in order to reduce mastectomy rate (22.8% vs. 5.6%; p < 0.001). No immediate reconstruction was offered during lockdown. 51.2% had co-morbidity, and 7.8% developed postoperative complications in lockdown. There was no peri-operative COVID-19 infection related morbidity or mortality. breast cancer can be safely provided during COVID-19 pandemic in selected patients. •A regional prospective cohort study on safety of breast surgery during COVID-19 pandemic.•Breast cancer surgery is safe in selected patients.•No COVID-19 infection related morbidity and mortality detected.