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How the COVID19 Pandemic affects Breast Cancer Diagnosis and Surgery


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Changes to our usual procedures for screening mammography and breast cancer surgery due to the COVID19 pandemic

Published in: Health & Medicine
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How the COVID19 Pandemic affects Breast Cancer Diagnosis and Surgery

  1. 1. How the COVID19 Pandemic affects Breast Cancer Diagnosis and Surgery Deanna J. Attai, MD FACS April 7, 2020
  2. 2. SARS-CoV-2 Novel coronavirus, no natural immunity Airborne spread, 2 -14 day latent period Travel-related or close contact Cough, shortness of breath, fever Asymptomatic carriers Older adults, immune compromised, cardiac and lung disease more susceptible Deaths reported in all age groups
  3. 3. 1.1 million* cases 57,000* deaths 208 countries, areas or territories *as of 04 April 2020   reports/20200404-sitrep-75-covid-19.pdf?sfvrsn=99251b2b_2
  4. 4. 280,000* cases 6500* deaths *as of 04 April 2020  us.html
  5. 5. Public Health Issues and Concerns Finite resources: hospitals, ICU beds, ventilators, healthcare personnel Shortage of personal protective equipment (PPE) Increased mortality from surgery Hospital-acquired infection Unclear if infection confers immunity
  6. 6. Public Health Recommendations Testing is limited Assume everyone could be carrier Personal distancing Stay at home orders Frequent hand-washing Do not touch face Mask when in public
  7. 7. “Flatten the Curve”  how-social-distancing-saves-lives
  8. 8. COVID-19 Pandemic: Breast Cancer Screening Postpone screening mammogram, ultrasound and MRI Diagnostic studies, biopsies still being performed “There is no evidence that delaying screening mammography for the proposed short time period will affect mortality but there is plenty of evidence that being exposed to the coronavirus can impact mortality”  ASBrS-ACR-Joint-Statement.pdf
  9. 9. COVID-19 Pandemic: Consultations and Office Visits Reduce number of patients being seen in person Helps to protect immune suppressed patients Telephone and video encounters when possible
  10. 10. COVID-19 Pandemic: Breast Cancer Surgery No surgery for benign conditions No risk reducing surgery Neoadjuvant chemotherapy and endocrine therapy Minimize general anesthesia Lumpectomy when possible No autologous flaps Outpatient facility if possible
  11. 11.   19_Pandemic_Breast_Cancer_Consortium_Recommendations_EXECUTIVE_SU MMARY.pdf?01  during-COVID-19-3.30.20.pdf  Breast-Reconstruction-Statement.pdf  on-Endocrine-Therapy-in-the-COVID-19-Pandemic.pdf?v1 COVID-19 Pandemic: Breast Cancer Surgery
  12. 12. Conclusions: Temporary but necessary measures to reduce exposure and preserve resources Individualized approach Reach out to medical team, mental health provider, friends/family Try to maintain healthy habits State / County public health offices for local information