Endocrine Therapies for ER-Positive Breast Cancer Patients during COVID-۱۹ Pandemic

The COVID-۱۹ pandemic has brought challenges in treating underlying diseases like cancer, especially in patients with breast cancer. Patients must be prioritized based on the urgency of treatment to minimize their exposure to the virus. Among breast cancer treatments like tamoxifen treatment, Neoadjuvant endocrine therapy (NeoET) is recommended for most subtypes of cancer, including estrogen receptor-positive (ER+) tumors, which delay surgery. However, tamoxifen treatment is associated with increased sensitivity to COVID-۱۹ due to its strong relationship with the Renin-angiotensin system (RAS).Material and Method:Articles and information from ۲۰۲۰ to ۲۰۲۲ were searched using the keywords of "COVID-۱۹", "Breast Cancer", and "Endocrine Therapy" in scientific databases like PubMed, Scopus, and Google Scholar.Results:The virus has a strong relationship with the RAS and disrupts it by blocking Angiotensin-converting enzyme ۲ and regulating aminopeptidase transformation. However, a high level of primary ER or a combination of ER-positive and progesterone receptor (PgR) positive can be used to select NoeET in tumor control. Survival differences in ductal carcinoma in situ (DCIS) patients treated with NoeET were also observed in the postoperative period, and patients with CT۲ tumors were more likely to receive NoeET than ACT۱ tumors. It is worth noting that the histological grade obtained from core needle biopsy and genomic tests can be taken into account before selecting the grades of NeoET.Conclusion:The COVID-۱۹ pandemic has made it essential to prioritize breast cancer patients based on the urgency of treatment. ER-positive breast cancer patients should consider alternative endocrine therapies like NeoET and chemotherapy for treatment during the pandemic. Healthcare providers must weigh the benefits and risks of tamoxifen treatment for ER-positive breast cancer patients, considering its association with increased sensitivity to COVID-۱۹.

کلیدواژه ها:

ER Positive ، COVID-۱۹ ، Breast Cancer ، Estrogen Receptor ، Endocrine Therapy