CLEVELAND — To an extent, we’re all feeling uncertain about what the future holds and what’s best during the pandemic, and that’s especially true for cancer patients and their doctors who are trying to navigate the needs of treatment against the risk of COVID-19.
Now, there’s new recommendations for breast cancer patients so doctor’s can make their difficult decisions, a little easier.
The American Society of Breast Surgeons released a summary of those guidelines, led by Dr. Jill Dietz the director of breast operations at University Hospitals Cleveland Medical Center and president of the American Society of Breast Surgeons.
“We were getting asked daily by our members to help guide them with these very difficult decisions of postponing treatment versus coming in for treatment,” said Dr. Dietz.
The manuscript is a collective work from the American Society of Breast Surgeons, the National Accreditation Program for Breast Centers, the National Comprehensive Care Network, the Commission on Cancer and the American College of Radiology.
It is based on a tiered ranking system for patients, looking at which patients need urgent care and which patients can wait until after the pandemic.
It categorizes patients into three levels: A, B and C.
“A priority A patient is somebody that, if they don't go to the operating room right now, that's a life threatening emergency,” she said.
B patients should start treatment before the pandemic ends, but could possibly do alternative treatment.
“The B's are where most breast cancer patients fall. So, these are patients who, some of them, can be given alternative therapy instead of have surgery and it's not going to impact their survival,” she said.
C patients can wait until the pandemic ends.
“So for instance, if you have a benign mass, that's a tumor called a fibroadenoma, it's completely benign,” said Dr. Dietz. “We don't recommend that you have it removed, because there's no improvement in your survival.”
At this point, the recommendations are just there to guide doctors and their patients.
But Dr. Dietz said healthcare providers are looking towards the future.
“Our next objective is to continue to gather the data, and to help people with those next steps. And those next questions about how long can we really wait? And should we be moving patients that have cancer to different areas that have less of a pandemic?” she said.
While there’s no clear answer yet, she is confident the summary will help doctors and patients.
“Fortunately, in general, women who have breast cancer do very well and we have many, many treatments that we can give patients to keep their cancer at bay, that won't change their survival and will allow them to be treated and still protect them from coming in being exposed,” said Dr. Dietz.
As for routine mammograms, Dr. Dietz said it’s OK to delay a few months. She said women should continue to self-monitor and if they feel a lump or anything of concern, they should call their doctors.
Though it is different if you know you’re high risk or have the BRCA gene.
“At some point, we don't want them to wait six months or a year, we want to bring them in sooner, but most everybody else can continue to monitor themselves,” she said.
To read the full summary click here.