Perioperative Concerns in Breast Cancer Surgery during Covid-19 Pandemic
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Statement of the Problem: Breast cancer is one of the most common cancers in women all over the world, with increasing incidences due to various reasons. These include greater awareness about the occurrence of breast cancer, early detection, increase in life-style and stress-related diseases, hormonal imbalances and diet. Operative treatment forms the mainstay of management along with chemotherapy and radiotherapy. The current COVID-19 pandemic is an eye opener for all the stakeholders in health-care sector. The inadequate health systems are currently overwhelmed by COVID-19, that other diseases like cancer have taken a back seat in most institutions. Breast cancer can spread further if surgical treatment is delayed in resectable tumors, resulting in increased morbidity and mortality. COVID testing must be done for patients posted for these surgeries. Complete asepsis must be maintained during patient handling and all procedures. In addition, regional anesthetic techniques must be utilized in all patients to reduce the stress response and anesthetic requirements. Conclusion & Significance: Breast cancer detection and management should not be delayed due to crisis due to COVID-19 pandemic. Such oncosurgeries must be done in dedicated non-COVID centers after requisite testing and taking adequate barrier precautions and asepsis. So far, no systematic reports are available regarding a higher incidence of COVID-19 or SARS-CoV2 asymptomatic infections in patients with cancer. Recent limited data from China, and more recently from Italy and the US, do however seem to confirm a higher risk.