新型冠状病毒肺炎疫情期间乳腺癌患者诊疗建议

Recommendation for diagnosis and treatment of breast cancer patients during COVID-19epidemic

目的乳腺癌患者受疾病或抗肿瘤治疗的影响,机体处于免疫低下状态,是2019新型冠状病毒肺炎(corona virus disease 2019,COVID-19)的易感人群之一。本研究为乳腺癌患者在COVID-19疫情期间提出诊疗建议。方法应用维普、知网、PubMed检索系统,以"新型冠状病毒肺炎、乳腺癌、指南、延迟、时机"或"COVID-19、breast cancer、guidelines、delaying、timeliness"等为检索词,检索2014-01-2020-01相关文献,共检索到英文文献19篇,中文文献12篇。纳入标准:(1)报道乳腺癌手术、化疗、放疗或内分泌治疗延迟治疗情况;(2)有关COVID-19诊治流程管理;(3)乳腺癌诊治指南。根据标准共纳入20篇文献。结果针对目前国内的疫情,对于常规复查患者,在病情稳定情况下可暂缓复查。对于晚期患者维持治疗阶段,应根据患者症状、肿瘤负荷,适当简化检查,重点检查靶病灶或症状明显的器官。对于内分泌治疗、靶向维持治疗、进行骨相关治疗、化疗及放疗的患者,应根据疾病分期和治疗阶段,维持或调整治疗方案。对于乳腺癌手术患者,可短时间暂缓手术。如确定要实施手术,应尽可能缩小手术范围,缩短手术时间。结论在COVID-19疫情的特殊时期,乳腺癌患者的治疗应遵循指南,合理诊治,科学防护。

OBJECTIVE Breast cancer patients are affected by the disease or anti-tumor treatment,resulting in a state of low immunity,so they are one of the susceptible populations of the COVID-19.This paper provided diagnosis and treatment recommendations for breast cancer patients during the epidemic of COVID-19.METHODS Articles were found in VIP,CNKI,PubMed from January 2014 to January 2020 with"COVID-19,breast cancer,guidelines,delaying,timeliness"as keywords.In all,19 English papers and 12 Chinese papers were searched.Choice criteria:(1)Delayed treatment for breast cancer surgery,chemotherapy,radiation,or endocrine therapy;(2)treatment of COVID-19;(3)Guidelines about breast cancer.According to the criteria,20 papers were analyzed and reviewed.RESULTS Based on the current domestic epidemic situation,for patients with routine reexamination,the reexamination can be postponed when the condition is stable.For advanced patients in the stage of maintenance treatment,the examination should be simplified appropriately according to the patient’s symptoms and tumor load,focusing on the target lesions or organs with obvious symptoms.For patients with endocrine therapy,targeted maintenance therapy,bone-related therapy,chemotherapy and radiotherapy,the treatment regimen should be maintained or adjusted according to the disease stage and treatment stage.For breast cancer patients,the operation can be suspended for a short time.If it is determined to perform the operation,the scope of the operation should be reduced as much as possible and the operation time should be shortened.CONCLUSIONS During the epidemic of COVID-19,the reasonable diagnosis and treatment of breast cancer patients should follow the guidelines.Scientific protection should be provided for patients and medical staff.