MRC Institute of Genetics & Molecular Medicine
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Guidelines for treatment of breast cancer patients with delays in surgery due to COVID-19

Investigators from the Cancer Research UK Edinburgh Centre helped develop evidence-based guidelines for managing patients with primary ER+ HER2− breast cancer deferred from surgery due to the COVID-19 pandemic: June 2020

Frequency of breast cancers with respect to the status of estrogen receptor (ER), human epidermal growth factor receptor 2 (HER2) and progesterone receptor (PR).
Frequency of breast cancers with respect to the status of estrogen receptor (ER), human epidermal growth factor receptor 2 (HER2) and progesterone receptor (PR).

An enormous international effort to date may have reduced the burden associated with the COVID-19, but the impact of coronavirus continues to cause major delay and disruption to cancer services across the UK. It is therefore imperative that cancer patients receive the best care available under current difficult circumstances. Delivery of such care benefits immensely from evidence based guidelines that help identify most vulnerable individuals and decide treatment prioritisation.

During the COVID-19 pandemic, many patients with ER+ HER2− primary breast cancer are being deferred from surgery to neoadjuvant endocrine therapy (NeoET). A multinational team of investigators, including Professor Mike Dixon and Doctor Arran Turnbull from the Edinburgh Cancer Research Centre, have collated data from multiple international clinical trials of presurgical endocrine therapy in order to provide guidance on the identification of patients who are suitable for treatment by neoadjuvant endocrine therapy. These guidelines also include how to identify patients with tumours that are not sensitive to endocrine therapy and who should be prioritised for early surgery or neoadjuvant chemotherapy rather than be treated with NeoET. These guidelines provide a structured approach to managing patients with early ER+ HER2− breast cancer during the COVID-19 pandemic. They have been published in the journal “npj Breast Cancer” in a study titled “Evidence-based guidelines for managing patients with primary ER+ HER2− breast cancer deferred from surgery due to the COVID-19 pandemic”.

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