Multidisciplinary team meeting and EUSOMA quality indicators in breast cancer care during COVID-19 outbreak in North-Eastern Italy. When the going gets tough, the tough gets going!

Background:It is widely accepted that multidisciplinary team meetings(MTM) ensure higher quality of care and improved survival in breast cancer(BC) patients. During the COVID-19 outbreak in Northern Italy, in the largeterritory of ULSS6“Euganea”(province of Padova, nearly one million peopleand 3 local hospitals: Cittadella–CTD, Camposampiero–CSP, Schiavonia-SCH) since the end of February 2020, SCH were turned into“COVID-19hospital”and BC cancer patients were then transferred to CTD in order tounderwent surgery. Prior to COVID-19 outbreak, MTM took place weekly,while during the COVID-19 emergency, MTM were largely suspended.Material and methods:This was a retrospective observational studyincluding patients newly diagnosed BC, discussed in pre- and/or post-therapeutic MTM between March 1st, 2019 and May 1st, 2019 compared tothe same period of 2020, during COVID-19 emergency. EUSOMA qualityindicators were evaluated and compared in order to establish the impact ofCOVID-19 outbreak in breast cancer patients’management in absence ofMTM.Results:Despite COVID-19 emergency, the time passed from the firstdiagnostic procedure to surgery/CT treatment was nearly the same in the twoperiods (41 ± 14 days in 2019, range 18–92 days versus 37 ± 19 days in2020, range 15–107 days; p = 0.3). The only parameter which drasticallychanged was the proportion of patients to be discussed in MTM (p adjustedfor false discovery rate = 0.002). However, the absence of MTM wassubstituted by a more point-to-point communication (oncologists/surgeons/radiologists directly communicating with the others) did not loosen thestraight organization of the procedures, as showed by the adherence to themost part of EUSOMA quality indicatorsConclusions:The presence of MTM in a beast unit is a powerful mean toassess quality in breast cancer patients’management. The well-establishedadherence to EUSOMA criteria and to standard procedures allowed us tomaintain the high qualityof breast cancercare and management, even duringthe COVID-19 outbreak in the Veneto region