COVID-19 Pandemic Breast Cancer Consortium’s Considerations for Re-entry: Clinical Guideline by The American Society of Breast Surgeons (ASBrS), the National Accreditation Program for Breast Centers (NAPBC), the National Comprehensive Cancer Network (NCCN), the Commission on Cancer (CoC) and the American College of Radiology® (ACR®).

https://www.breastsurgeons.org/docs/covid19/reentry.pdf?v1

Coronavirus Disease-2019 (COVID-19) is the most widespread coronavirus pandemic in history, wreaking havoc across the globe as governments work to limit its transmission and mortality, primarily through social distancing. The causative agent, Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV-2) results in a spectrum of clinical presentations including fulminant COVID-19, whose fatality rate varies by age and comorbidities. In the United States, elective medical procedures have been postponed in order to conserve personal protective equipment (PPE), create hospital capacity, and protect patients needing non-urgent surgery and other procedures from exposure to the virus in the hospital setting. The latter aim is particularly relevant to breast cancer patients, whose immune systems may be compromised by both disease and treatment, placing them at increased risk of COVID-19 infection and its serious complications.

There will be regional differences in how individual providers and institutions will begin to normalize the care of breast patients. These will depend on the incidence and prevalence of COVID-19 cases in the region and factors specific to the facility itself; the resources available including PPE, ventilators, operating rooms and staff to care for patients as well as the ability to create a virus-free space for the safety of patients.

If you have breast cancer and are currently infected with SARS-CoV2 or are being treated for COVID-19, you should consult your breast surgeon or physician about the most appropriate steps for your care. In general, however, most early stage breast cancer patients can have surgery and chemotherapy deferred until the viral infection is cleared, which typically occurs within 20 to 30 days, and the patient has clinically recovered.

Ask your breast surgeon or physician about the risks of delayed treatment and the risks of virus exposure during surgery and treatment visits, if you are immunocompromised from cancer therapies.