Breast cancer management pathways during the COVID-19 pandemic: outcomes from the UK ‘Alert Level 4’ phase of the B-MaP-C study
Creators: name: Dave, Rajiv V.
name: Kim, Baek
name: Courtney, Alona
name: O’Connell, Rachel
name: Rattay, Tim
name: Taxiarchi, Vicky P.
name: Kirkham, Jamie J.
name: Camacho, Elizabeth M.
name: Fairbrother, Patricia
name: Sharma, Nisha
name: Cartlidge, Christopher W. J.
name: Horgan, Kieran
name: McIntosh, Stuart A.
name: Leff, Daniel R.
name: Vidya, Raghavan
name: Holcombe, Chris
name: Copson, Ellen
name: Coles, Charlotte E.
name: Cutress, Ramsey I.
name: Gandhi, Ashu
name: Kirwan, Cliona C.
name: Agrawal, Amit
name: Benson, John
name: Forouhi, Parto
name: Wignarajah, Primeera
name: Shrotri, Anu
name: Kattakayam, Arjun
name: Noronha, Jarin Louis
name: Martin, Lee
name: Lafi, Mohamed
name: Hardy, Rob
name: Amin, Khalid
name: AL-Zawi, Abdalla Saad Abdalla
name: Elamass, Mohamed
name: Salih, Ali
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name: Hill, Arnold D. K.
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name: Allen, Michael J.
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name: Zammit, Charles
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name: Seward, Joanna
name: Mathers, Helen
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name: Salman, Reem
name: Shin, Hyunjin
name: Turner, Jane
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name: Horne, Sarah
name: Sarakbi, Wail Al
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name: Jacklin, Rosamond
name: Chandrasekharan, Sankaran
name: Marsh, Simon
name: Saha, Sunita
name: Wilson, Christopher
name: Rutherford, Claire Louise
name: Doughty, Julie
name: Romics, Laszlo
name: Stallard, Sheila
name: Chaudhry, Anushka
name: Peck, Jennifer
name: Coombs, Nathan
name: Williams, Samantha K.
name: Hawkins, Simon
name: Kothari, Ashutosh
name: Hamed, Hisham
name: Jain, Urvashi
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name: Mullen, Russell
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name: Khalifa, Eiman
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name: Elahi, M. Bilal
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name: Robb, Henry Douglas
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name: Bakri, Nur Amalina Che
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name: Sait, Mohamed Razick
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name: Hamad, Ahmed
name: Goyal, Amit
name: Carmichael, Amtul
name: Courtney, Carol-Ann
name: Sibbering, David Mark
name: Garreffa, Emanuele
name: Cheung, Kwok-Leung
name: Williams-Jones, Susan
name: Wahedna, Yasmin
name: Ansari, Aonghus
name: Kenny, Frances
name: Valassiadou, Kalliope
name: Lambert, Kelly
name: Krupa, Jaroslaw
name: Sardar, Mini V.
name: Kaushik, Monika
name: Shokuhi, Sheila
name: Pilgrm, Simon
name: Sasi, Walid
name: McManus, Penelope
name: Parmeshwar, Rishikesh
name: Somasundaram, Santosh
name: Gowda, Manoj
name: Jafferbhoy, Sadaf
name: Narayanan, Sankaran
name: Marla, Sekhar
name: Soumian, Soni
name: Goh, Ngee-Ming
name: Vatish, Jamie
name: Sein, Tin Aung
name: Agabiti, Ennio
name: Maalo, Joseph
name: Chong, Kelvin
name: Lai, Lee-Min
name: Elkorety, Mohamed
name: Monib, Sherif
name: Thomson, Simon
name: Mikhael, Youhana
name: Mirshekar-Syahkal, Bahar
name: Aitken, Jane
name: Girgis, Mina
name: Betal, Dibendu
name: Rapisarda, Fabio
name: Cook, Lorna
name: Odofin, Olubunmi
name: Bonomi, Riccardo
name: Wardle, Stacy
name: Sotheran, Wendy
name: Athanasiou, Irene
name: Lund, Jonathan
name: Callaghan, Maria
name: Burrah, Rajaram
name: Vinayagam, Raman
name: James, Karen
name: Poonawala, Shabbir
name: Isgar, Brian
name: Matey, Pilar
name: Mylvaganam, Senthurun
name: Podesta, Carl
name: Sircar, Tapan
name: Salem, Fathi
name: Al-Ishaq, Zaid
Publisher: name: Apollo - University of Cambridge Repository
Year: 2021
Subjects: Article
/692/4028/67/1347
/692/4028/546
/692/700/3934
/692/700/784
/692/700/1538
article

description: Abstract: 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.