Imperial College London
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Mr Daniel Richard Leff

Faculty of Medicine, Department of Surgery & Cancer

Reader in Breast Surgery
 
 
 
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Contact

 

d.leff Website

 
 
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Location

 

016Paterson WingSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Dave:2021:10.1038/s41416-020-01234-4,
author = {Dave, RV and Kim, B and Courtney, A and O'Connell, R and Rattay, T and Taxiarchi, VP and Kirkham, JJ and Camacho, EM and Fairbrother, P and Sharma, N and Cartlidge, CWJ and Horgan, K and McIntosh, SA and Leff, DR and Vidya, R and Potter, S and Holcombe, C and Copson, E and Coles, CE and Cutress, RI and Gandhi, A and Kirwan, CC and B-MaP-C, study collaborative},
doi = {10.1038/s41416-020-01234-4},
journal = {British Journal of Cancer},
pages = {1785--1794},
title = {Breast cancer management pathways during the COVID-19 pandemic: outcomes from the UK 'Alert Level 4' phase of the B-MaP-C study},
url = {http://dx.doi.org/10.1038/s41416-020-01234-4},
volume = {124},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: The B-MaP-C study aimed to determine alterations to breast cancer (BC) management during the peak transmission period of the UK COVID-19 pandemic and the potential impact of these treatment decisions. METHODS: This was a national cohort study of patients with early BC undergoing multidisciplinary team (MDT)-guided treatment recommendations during the pandemic, designated 'standard' or 'COVID-altered', in the preoperative, operative and post-operative setting. FINDINGS: Of 3776 patients (from 64 UK units) in the study, 2246 (59%) had 'COVID-altered' management. 'Bridging' endocrine therapy was used (n = 951) where theatre capacity was reduced. There was increasing access to COVID-19 low-risk theatres during the study period (59%). In line with national guidance, immediate breast reconstruction was avoided (n = 299). Where adjuvant chemotherapy was omitted (n = 81), the median benefit was only 3% (IQR 2-9%) using 'NHS Predict'. There was the rapid adoption of new evidence-based hypofractionated radiotherapy (n = 781, from 46 units). Only 14 patients (1%) tested positive for SARS-CoV-2 during their treatment journey. CONCLUSIONS: The majority of 'COVID-altered' management decisions were largely in line with pre-COVID evidence-based guidelines, implying that breast cancer survival outcomes are unlikely to be negatively impacted by the pandemic. However, in this study, the potential impact of delays to BC presentation or diagnosis remains unknown.
AU  - Dave,RV
AU  - Kim,B
AU  - Courtney,A
AU  - O'Connell,R
AU  - Rattay,T
AU  - Taxiarchi,VP
AU  - Kirkham,JJ
AU  - Camacho,EM
AU  - Fairbrother,P
AU  - Sharma,N
AU  - Cartlidge,CWJ
AU  - Horgan,K
AU  - McIntosh,SA
AU  - Leff,DR
AU  - Vidya,R
AU  - Potter,S
AU  - Holcombe,C
AU  - Copson,E
AU  - Coles,CE
AU  - Cutress,RI
AU  - Gandhi,A
AU  - Kirwan,CC
AU  - B-MaP-C,study collaborative
DO  - 10.1038/s41416-020-01234-4
EP  - 1794
PY  - 2021///
SN  - 0007-0920
SP  - 1785
TI  - Breast cancer management pathways during the COVID-19 pandemic: outcomes from the UK 'Alert Level 4' phase of the B-MaP-C study
T2  - British Journal of Cancer
UR  - http://dx.doi.org/10.1038/s41416-020-01234-4
UR  - https://www.ncbi.nlm.nih.gov/pubmed/33767422
UR  - https://www.nature.com/articles/s41416-020-01234-4
UR  - http://hdl.handle.net/10044/1/87425
VL  - 124
ER  -
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