Evidence-based guidelines for managing patients with primary ER+ HER2− breast cancer deferred from surgery due to the COVID-19 pandemic

• DOI: 10.1038/s41523-020-0168-9
• Publication Date: 2020-06-08T10:05:16Z
• Authors: Mitch Dowsett; Matthew J. Ellis; J. Michael Dixon; Oleg Gluz; John Robertson; Ronald Kates; Vera J. Suman; Arran K. Turnbull; Ulrike Nitz; Matthias Christgen; Hans Kreipe; Sherko Kuemmel; Judith M. Bliss; Peter Barry; Stephen R. Johnston; Samuel A. Jacobs; Cynthia X. Ma; Ian E. Smith; Nadia Harbeck
• Keywords: Pandemic; Neoadjuvant Therapy; Breast-conserving surgery

Abstract Many patients with ER+ HER2− primary breast cancer are being deferred from surgery to neoadjuvant endocrine therapy (NeoET) during the COVID-19 pandemic. We have collated data multiple international trials of presurgical in order provide guidance on identification who may insufficiently endocrine-sensitive tumors and should be prioritised for early or chemotherapy rather than NeoET aftermath pandemic safety when surgical activity needs prioritized. For postmenopausal patients, our strong support use ER PgR status at diagnosis triaging into three groups which (taking account clinical factors): (i) is likely inappropriate (Allred <6 6 <6) (ii) a biopsy Ki67 analysis (on-treatment Ki67) could considered after 2–4 weeks (a: 7 8 b: ≥6) (iii) an acceptable course action (ER ≥6). Cut-offs percentage cells positive also given. group (ii), high on-treatment level (>10%) indicates higher priority surgery. Too few were available premenopausal similar treatment algorithm. These guidelines helpful managing crisis.