How long should breast cancer patients whose surgeries are delayed due to COVID-19 remain on neoadjuvant endocrine therapy?

For patients with low risk, early stage, HR+/HER2- breast cancer who initiated endocrine therapy in order to delay their surgery due to the COVID 19 epidemic, what would be the ideal duration of endocrine therapy? Should such patients continue for 4-6 months in order to assess their response to neo-adjuvant chemotherapy? Alternatively, should such patients move forward with the surgery as soon as COVID-19 restriction for breast surgeries are lifted?

3 Answers

Mednet MemberInvited Expert

Medical Oncology · University of North Carolina

Answered on

How long to continue neoadjuvant endocrine therapy (NET) when it was initiated for the purposes of COVID-19 management depends on several variables, including whether the tumor is at least stable on NET (if not, then conversion to surgery or chemotherapy is appropriate), and what the COVID-19 trajectory is in your community. Many communities are finding a lower, flatter curve, meaning both that we are unlikely to have catastrophic limitations of health resources (beds, ventilators), but also tha...

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Mednet MemberInvited Expert

Medical Oncology · University of Pittsburgh School of Medicine

Answered on

I completely agree with @Dr. First Last here. We tended to do this with older women who are/were not fit for surgery in the pre-COVID era. There is no reason not to continue this practice now.

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Mednet MemberInvited Expert

Medical Oncology · University of Texas MD Anderson Cancer Center

Answered on

I strongly agree with @Dr. First Last's recommendation. Multiple clinical trials showed the safety and efficacy of this approach.

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