Systematic Reviews
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Jan 24, 2021; 12(1): 31-42
Published online Jan 24, 2021. doi: 10.5306/wjco.v12.i1.31
Adaptation of international coronavirus disease 2019 and breast cancer guidelines to local context
Guillermo Arturo Valencia, Silvia Neciosup, Henry L Gómez, Maria Del Pilar Benites, Silvia Falcón, David Moron, Karin Veliz, Mike Maldonado, Rodrigo Auqui
Guillermo Arturo Valencia, Silvia Neciosup, Henry L Gómez, Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplásicas (INEN), Surquillo 15000, Lima, Peru
Silvia Neciosup, Henry L Gómez, Clínica Oncosalud – AUNA, Surquillo 15000, Lima, Peru
Maria Del Pilar Benites, Breast Cancer Unit, Hospital Nacional Edgardo Rebagliati Martins, Lima 15000, Peru
Silvia Falcón, Department of Medical Oncology, Centro Oncológico Aliada, Lima 15000, Peru
David Moron, Department of Medical Oncology, Hospital Nacional Carlos Alberto Seguín Escobedo, Arequipa 04001, Peru
Karin Veliz, Department of Medical Oncology, Hospital Nacional Ramiro Prialé Prialé, Huancayo 12000, Peru
Mike Maldonado, Department of Medical Oncology, Instituto Regional de Enfermedades Neoplásicas (IREN), Trujillo 13001, Peru
Rodrigo Auqui, Department of Medical Oncology, Hospital Nacional Almanzor Aguinaga Asenjo, Chiclayo 14001, Peru
Author contributions: Valencia GA wrote the paper and collected data; All the authors discussed the review article and made a consensus by vote.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Guillermo Arturo Valencia, MD, Medical Assistant, Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplásicas (INEN), Angamos Este Avenue 2520, Surquillo 15000, Lima, Peru. guillermo.valencia.mesias@gmail.com
Received: September 4, 2020
Peer-review started: September 4, 2020
First decision: November 16, 2020
Revised: November 23, 2020
Accepted: December 4, 2020
Article in press: December 4, 2020
Published online: January 24, 2021
ARTICLE HIGHLIGHTS
Research background

The evaluation of the reality of access to health services in our country (Peru) is mandatory in coronavirus disease 2019 (COVID-19) era as is the prioritization of different approaches to determine which patients with cancer [in this case with breast cancer (BC)] need immediate treatment or those in which treatment can be deferred until pandemic is over. BC is one of the most frequent tumors in Peru, similar to other countries of Latin America and globally.

Research motivation

In Peru there is no information about a consensus or local guidelines of BC and COVID-19 management.

Research objectives

The main objective is to adapt international clinical practice guidelines to local context through best decision-makers, avoid duplication of efforts, and optimize medical resources, since Peru has many limitations to access a optimal health care attention.

Research methods

Peruvian Society of Medical Oncology invited an expert panel (including nine medical oncologists, opinion leaders in Peru) who reviewed and were asked to cast their vote. Decisions were discussed with a consensus though teleconference. One hundred twelve recommendations were reviewed, and priority categories were defined and adapted in three levels based on the severity and urgency of an individual patient’s conditions or treatments. Finally, some comments were allowed in each topic discussed.

Research results

Recommendations about human epidermal growth factor receptor 2 and triple-negative subtypes were quite similar, but in the luminal subtype there are more options for clinical decisions since treatment of different scenarios (mainly metastatic BC) has evolved in the last few years.

Research conclusions

Majority of recommendations were reviewed and adapted from international clinical practice guidelines to local context.

Research perspectives

The authors believe that this manuscript will be useful for other Latin America countries to adapt health policies in the COVID-19 era.