Primary Aim

To document and describe breast cancer management (surgery, neoadjuvant / adjuvant chemotherapy and radiotherapy) during the COVID-19 pandemic and compare this to current (pre-COVID-19) management practice.

Secondary aims

Short term:

  • The proportion of patients on ‘bridging’ neoadjuvant endocrine therapy who progress or fail to respond and so require surgery for clinical reasons earlier than anticipated.
  • The proportion of patients planned for breast conserving surgery, having completion mastectomy for oncological reasons due altered indications for radiotherapy.
  • The rate of delayed reconstruction for patients who requested immediate reconstruction (and having simple mastectomies instead).
  • Proportion of presumed DCIS found to have an invasive component at surgery (usually ~20%).
  • The proportion of patients having COVID-altered adjuvant therapies (e.g. omission of radiotherapy or systemic chemotherapy/targeted therapies).

Long term:

To gather a national cohort of patients with COVID-altered treatment pathways that can be interrogated in the future for oncological outcomes, including but not limited to:

  • Risk of increased loco-regional recurrence and/or poorer overall survival in patients having breast conserving surgery, and omitted radiotherapy.
  • Risk of increased loco-regional recurrence and/or poorer overall survival in patients having omitted neoadjuvant / adjuvant chemotherapy +/- targeted anti-HER2 therapy.
  • Risk of disease progression and/or poorer overall survival in premenopausal and postmenopausal patients on ‘bridging’ primary endocrine therapy having delayed surgery.