Breast Cancer Coverage from Every Angle

SABCS 2020: Provider Survey on Managing Early-Stage Breast Cancer Amid COVID-19

By: Julia Fiederlein
Posted: Tuesday, December 15, 2020

Ko Un Park, MD, of The Ohio State University Wexner Medical Center, Columbus, and colleagues conducted a multicenter survey analysis to evaluate the patterns for managing patients with early-stage estrogen receptor–positive breast cancer during the first several months of the COVID-19 pandemic. The results were presented during the virtual 2020 San Antonio Breast Cancer Symposium (SABCS; Abstract SS2-05) and revealed that most providers utilized neoadjuvant endocrine therapy until surgery could proceed.

“During the COVID-19 pandemic in the United States, neoadjuvant endocrine therapy use has been recommended to allow safe deferral of surgical treatment,” the investigators remarked. “After neoadjuvant endocrine therapy use, there is limited guidance on locoregional treatment, especially with management of the axilla.”

The survey was administered to 42 medical oncologists, 14 radiation oncologists, and 58 surgeons. Prior to the COVID-19 pandemic, most providers rarely (46%) or sometimes (33%) used neoadjuvant endocrine therapy. A total of 46% and 21% of providers were willing to delay surgery up to 2 and 3 months, respectively, without the use of neoadjuvant endocrine therapy (P < .05). Compared with radiation oncologists (75%) and surgeons (60%), more medical oncologists (90%) stated they would perform genomic assays on biopsy specimens from all or select patients prior to the initiation of neoadjuvant endocrine therapy (P < .05).

The majority of providers (81%) preferred to administer tamoxifen to premenopausal patients and aromatase inhibitors to postmenopausal patients. According to the investigators, most providers planned to use neoadjuvant endocrine therapy for as little time as possible until surgery could proceed. Omitting axillary lymph node dissection after 1, 2, or 3 months was recommended by 60%, 59%, and 53% of providers, respectively. As the therapy duration increased, more providers seemed to favor axillary lymph node dissection in patients with low-volume axillary metastatic disease.

Disclosure: For full disclosures of the study authors, visit

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