MO33-7 Preparedness for COVID-19 pandemic and impact on medical oncology for breast cancer

Background: An emergency framework was set to confront the first wave COVID-19 pandemic at the medical oncology division for breast cancer at the Cancer Institute Hospital of JFCR, Tokyo, in March 2020. Medical therapy was classified into two phases in our guideline. In the initial phase, workload or patients' visit was to be reduced without impairing disease control and survival. In the successive phase under restriction of medical resources, only therapies with higher priority and alternate therapies were to be practiced. Whereas no significant effect on medical practice was observed during first wave pandemic, actual impact was evaluated in this study. Methods: Among patients in our division from April to May 2020, cases of treatment change, postponement of treatment introduction, treatment interruption, long-term prescription, telephone consultation, postponement of visit, reference to other hospital, and COVID-19 diagnosis were retrospectively searched from medical records. Results: There were estimated 984 patients, 389 perioperative and 595 metastatic, of whom 119(12%) were affected by COVID-19. The breakdown is 7 cases of treatment changes, 7 cases of postponements of introduction, 20 cases of interruptions, 12 cases of long-term prescriptions of oral chemotherapy and molecular targeted therapy, 36 cases of prescriptions by telephone consultation, 94 cases of postponements of visit, 3 cases of reference to other hospital, and 4 cases of fever for which COVID-19 infection could not be denied. Conclusion: 12% of patients in the division of medical oncology at the breast center changed their treatment or schedule of visit. Treatment change that could affect breast cancer survival were 2 cases of cancellation of adjuvant chemotherapy. The effect might have been minimized by formulation of a COVID-19 guideline prior to the pandemic.