الفهرس 
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Abstract
COVID-19, originated in the city of Wuhan, Hubei Province, Central China, is a highly infectious disease caused by acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and responsible for the ongoing pandemic, with the beginning of January 2022, there are more than 298,194,606 cases and more than 5,468,069 deaths had been confirmed worldwide.
Coronavirus disease 2019 has had enormous effects on healthcare systems worldwide with the elderly and people with underlying diseases or low immune function as cancer patients are more likely to become severe cases. The novel CoV can be transmitted between humans via respiratory droplets. Close contact is also a source of transmission of SARS-CoV-2, that’s why all the decisions made were primarily to decrease the human-to-human contact as much as possible.
Breast cancer is the most common cancer and the leading cause of cancer death in women worldwide, Early-stage breast cancer, which is our study population, is defined as disease confined to the breast with or without regional lymph node involvement, and the absence of distant metastatic disease. For nonmetastatic breast cancer, the main goals of therapy are eradicating tumor from the breast and regional lymph nodes and preventing metastatic recurrence.
Surgery alone will result in long-term survival for some patients. Systemic therapy and local radiation can significantly improve the chances for long term survival, depending on the stage of disease, and biologic subtype of breast cancer.
The measures required to alleviate the burden on healthcare systems due to COVID-19 have strongly affected patients with breast cancer, especially the postponed surgeries. Accordingly, worldwide measures to alleviate the burden on healthcare systems, such as the suspension of elective surgeries and decision making regarding the pre and postoperative continuum of care follow up schedule, were implemented.
This is what posed a challenge to breast cancer care and hence the idea of the study came into mind in order to describe the change in management happened during the pandemic and whether there was an impact or no to the ongoing pandemic on the continuum of care to our cancer patients at our institution.
The total population of the study were included by the above mentioned inclusion criteria, no study sample was done, all who fit were included for more statistical power to our results, the population were divided into 2 groups, group A were the patients treated during the pandemic and our study group who were examined for the new management strategies and group B who were our comparative group, the patients treated before the pandemic and was considered the standard of care at our institution.
There was a statistically significant impact of the covid-19 pandemic as discussed above over the management plans for the patients who presented during the pandemic, with measure taken to decrease the frequency of visits to the hospital, more emphasize over the prophylactic supportive treatment to decrease the admission needed side effects, all in a trail to decrease the contact of immunosuppressed patients to decrease the like-hood of contacting the virus and worsen their condition, the change of treatment lines as more use of 3 weeks regimens more than weekly, 3 cycles protocol and duplet protocols instead of triplet protocols were not me by change in side effects and hence the decisions were considered preliminary accepted and advisable, more surveillance is needed for such patients to evaluate the progression free survival and overall survival.
More trials and prospective studies are needed to generate solid data and evidence-based guidelines to guide humanity during the ongoing pandemic and prepare us more for the future pandemics to come, in order to give the best care possible to our patients who are especially vulnerable subgroup of chronically ill patients.