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Patients with breast cancer in the past who have completed their treatment (Chemotherapy, Radiotherapy) and are not receiving any treatment or are only on Hormone Therapy, are NOT a high-risk group for this specific reason – “cancer patients”

Surgeries postponed until later:

• treatment of benign disease (atypia, fibroadenoma, discharge-possible papilloma, etc.)
• breast reconstruction after mastectomy (initial or 2nd phase)
• prophylactic risk-reducing surgery (bilateral mastectomy)
• all cosmetic breast surgeries (enlargement, reduction, lift, etc.)

Exceptions: drainage of a breast abscess, postoperative hematoma, necrosis of a recently repaired flap

• Diagnosis of non-invasive cancer (DCIS) in a core biopsy

• ER-positive: initial treatment with Hormone Therapy (Tamoxifen or Aromatase Inhibitor)

• ER-negative: currently monitoring if there is no evidence of invasive disease

• ER-positive and Low-risk factors: initial treatment with Hormone Therapy (Tamoxifen or Aromatase Inhibitor, in premenopausal patients and ovarian suppression)

• ER-positive and High-risk factors: initial treatment with Chemotherapy

• ER/PR/HER2 negative (Triple-negative disease) or HER2 positive: preoperative Chemotherapy

 Exception: early stage disease (small tumor) should be operated on

• Patients who have completed pre-operative chemotherapy and have a partial or complete response

• ER – positive tumor: start of hormone therapy and brief reassessment (in 1 month)

• ER – positive and HER2 positive tumor: anti-HER2 treatment, start of hormone therapy and brief reassessment (in 1 month)

• EP/PR/HER2 negative (Triple negative disease): should undergo surgery (within a month)

Patients who should undergo surgery immediately:

• • diagnosis of breast angiosarcoma or malignant phyllodes tumor

  • patients receiving pre-operative systemic therapy (Chemotherapy or Hormone Therapy) and disease progression is detected

Patients on chronic follow-up:

• • all scheduled “follow-up” tests are postponed

  • exception: appearance symptomatology of suspected metastasis development

Note: in all of the above, the possible coexistence of other factors that make the patient particularly at high risk in the event of COVID-19 disease should also be assessed, such as: chronic respiratory disease, cardiovascular disease, obesity, etc.