Our Experience of Breast Cancer Surgeries in COVID-19 Pandemic
Author(s): A. Mumtaz, J. Mohsin, R. Zaheer, A. Jamal, M. A. Parvaiz, M. Z. Chouhdhry, A. I. Khan
Objective This study provides an insight of the impact of the COVID-19 pandemic on the breast surgical field in our setup. We will summarize the safety measures we adapted over the time span of COVID-19 pandemic and also decision making in prioritizing patients with respect to tumor biology, stage and phase of treatment and effects of COVID-19 on post op patients in terms of morbidity and mortality. In addition we will discuss new aspects of patient-healthcare worker communication.
Materials and Methods A retrospective study at a single institution was reviewed from April 2020 to June 2020. Patients operated for breast cancer only included in this study to estimate their chances of getting COVID-19 infection or if operated after contracting COVID -19 infection what is their probability to develop pulmonary complications in 30 days period post op.
Results After collecting data we have refined our results on the basis of COVID-19 pandemic. Our discussion will be based on following main points i-e General hospital policies, development of health care workers protection against COVID-19, prioritizing surgeries, new ways of communication with patient and impact of our policies during pandemic on patient care. Total 258 patients included in study. In April, May and June, 57, 103, 98 patients were offered surgery respectively. Out of Total, upfront surgeries were 56 and post chemotherapy was 202. Patients with tumor biology of ILC were 18 and IDC were 234, DCIS 5 and 1 occult breast primary. Total 192 patients were hormone receptor positive and 74 were Her2neu expression positive. In month of June 15 patients were operated who were COVID positive 2 weeks earlier to surgery dates. On completing 2 weeks after being diagnosed as case of COVID-19, as per hospital policy, symptom free patients were offered surgery. No patient developed post op pulmonary complications.
Conclusion This COVID-19 era has set new challenges in healthcare but in our experience cancer surgeries can continue without fear of making patients more susceptible to contract this infection by observing full SOPs in a country with scarce resources like ours where all medical supplies were limited and vastly affected by COVID-19.