Abstract PO-007: Breast cancer management during COVID-19 outbreak: Learned lessons
Authors: Sánchez Juana María Brenes , Picado Amanda López , Sáenz José Ángel García , Crespo María Eugenia Olivares , De La Plata Merlo Rosa María , De La Muela María Herrera 
Published: December 2020

Abstract
Purpose: From the first case of COVID-19 infection in Wuhan (China), the infection spread westward around all the world, causing a pandemic. Madrid has been one of the more impacted cities worldwide due to this infection. BC (breast cancer) remains a major public health problem due to its high incidence, prevalence, and mortality. Surgical treatmentss were cancelled and postponed within the worse weeks of the pandemic in our BC Unit, located inside San Carlos Clinical Hospital in Madrid. We aimed to ensure the safety while maintaining the highest health care quality assisting our BC patients during the COVID-19 outbreak.
Patients and Methods: All consecutive patients newly diagnosed with BC, patients undergoing neoadjuvant therapy approaching to definitive for surgery, and patients whose surgical treatments were canceled, since March 15th to April 21st, were included in our analysis. Our multidisciplinary team triaged these BC patients and patient treatments were rescheduled including primary genomic platforms and harmonizing the antitumor systemic treatment. Telemedicine was used to evaluate the eventual side effects and to avoid unnecessary hospital visits, minimizing the exposure to COVID-19 risk infection.
Results: Surgical treatment was delayed in seven diagnosed cases of CDIS (ductal carcinoma in situ). Six patients with invasive triple-negative BC stage I-III underwent docetaxel plus CBDCA neoadjuvant systemic treatment. Two additional CBDCA-monotherapy cycles were scheduled in two patients in this TNBC group because the surgery had to be postponed. Both patients achieved a pCR. Ten patients with HER+ 2+ BC either ER+ or ER- early (stages I-III) BC received antiHER2-based neoadjuvant chemotherapy (taxanes plus trastuzumab and pertuzumab). Double neoadjuvant antiHER2 moAB followed beyond the 12-18 weeks until a safer time to perform surgery was obtained. Eight out of 13 luminal breast cancer patients underwent the 21 gene recurrence score (RS) assay at the time of the diagnosis. High RS (&gt;25) was found in 2 patients, so they received taxane-based neoadjuvant chemotherapy. Patients with low RS (&lt;25) received neoadjuvant endocrine therapy (w/o LH/RH analogs if needed). The full cohort of our patients agreed on the perceived quality of care.
Conclusion: Our patients received oncology primary treatments according to the molecular tumor subtypes until the surgery was safe. The role of interdisciplinary committee and the molecular platforms in neoadjuvant scenario allowed us to ensure safety and quality of care during the COVID outbreak. These strategies could be useful if a second viral wave appears.
Citation Format: Juana María Brenes Sánchez, Amanda López Picado, José Ángel García Sáenz, María Eugenia Olivares Crespo, Rosa María De La Plata Merlo, María Herrera De La Muela. Breast cancer management during COVID-19 outbreak: Learned lessons [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr PO-007.