key: cord-0794009-huinttya authors: Toss, Angela; Lambertini, Matteo; Punie, Kevin; Grandi, Giovanni; Cortesi, Laura title: BREAST CANCER SCREENING OF MUTATION CARRIERS IN THE ERA OF COVID‐19 PANDEMIC date: 2020-06-17 journal: Int J Cancer DOI: 10.1002/ijc.33160 sha: 406c06c1bc50672e80d25008c87a6332572dfd19 doc_id: 794009 cord_uid: huinttya nan attain very high incidence rates, containment measures were implemented to prevent infections both of patients and healthcare professionals. On these grounds, the American Society of Breast Surgeons (ASBrS), the National Accreditation Program for Breast Centers (NAPBC), the National Comprehensive Care Network (NCCN), the Commission on Cancer (CoC) and the American College of Radiology (ACR) provided preliminary guidance on the prioritization and treatment of breast cancer during this particular period [2] . Parallel, many national and international associations, cancer centers and research groups published their recommendations driven by the common goal to preserve hospital resources for COVID19 patients by prioritizing breast cancer management strategies [3] [4] [5] [6] . In line with the other national oncological association, on April 25, 2020 the Italian Association of Medical Oncology (AIOM) published a Special Communication providing guidelines, including selection criteria to service provision and prioritization of breast cancer treatments [7] . The majority of these guidelines agreed that population mammographic screening and screening of mutation carriers should have been suspended until the pandemic has subsided, while one recommended to continue screening in BRCA carriers <40 years of age if delays of >6 months were expected. Moreover, risk-reducing breast surgery has been given low priority with a clear preference to delay these procedures. Nevertheless, it is noteworthy that population mammographic screening significantly differs from cancer screening of mutation carriers for some crucial points. First of all, the most common screen-detected breast cancer is the luminal-like subtype, more frequently of low grade, small size and node-negative [8] [9] [10] . It is likely that a delay of a few months of these diagnoses does not significantly impact on patients' outcomes. On the other hand, mutation carriers, especially BRCA1 mutation carriers, are more frequently affected by high grade triple-negative tumors and high grade serous ovarian carcinomas. Early detection of these tumors is of utmost importance to improve clinical outcomes. Delays of 3-6 months leads to a prolonged interval to therapy initiation and can therefore compromise the patient's prognosis [11, 12] . Moreover, it should be noted that risks for hospital admission and critical illness of COVID-19 are associated with age and male sex [13, 14] . Indeed, while women attending the population mammographic screening are mostly aged >50 years, cancer screening of mutation carriers usually start at 25 years old. This means that the median age of high-risk women attending the screening of mutation carriers is lower than the population screening, and these women represent a population less prone to develop the worst clinical picture of COVID-19. This article is protected by copyright. All rights reserved. Call for Ensuring Cancer Care Continuity During Recommendations for prioritization, treatment, and triage of breast cancer patients during the COVID-19 pandemic. the COVID-19 pandemic breast cancer consortium Breast Cancer Diagnosis, Treatment and Follow-Up During editorial board of The Breast, Recommendations for Triage, Prioritization and Treatment of Breast Cancer Patients During the COVID-19 Pandemic Cancer care during the spread of coronavirus disease 2019 (COVID-19) in Italy: young oncologists' perspective. ESMO Open ESMO Management and treatment adapted recommendations in the COVID-19 era Special comunication: Gestione delle pazienti con carcinoma mammario durante la pandemia COVID-19 Tumor Characteristics in Screen-Detected and Symptomatic Breast Cancers Tumor Characteristics Associated With Mammographic Detection of Breast Cancer in the Ontario Breast Screening Program Differences in subtype distribution between screen-detected and symptomatic invasive breast cancer and their impact on survival Influence of delay on survival in patients with breast cancer: a systematic review Rachet B; ICBP Module 1 Working Group. Stage at diagnosis and ovarian cancer survival: evidence from the International Cancer Benchmarking Partnership Factors associated with hospital admission and critical illness among 5279 people with coronavirus disease The gendered impact of coronavirus disease (COVID-19): do estrogens play a role?