4 tips to help maintain breast imaging services during local COVID flare-ups

As radiology practices attempt to work through backlogs of breast studies, some patients and providers are being forced to pull back as COVID cases flare-up in certain geographies. Italian imaging experts, however, are offering a few safety tips this week for their peers.

That’s been the case in Texas where recent outbreaks of the novel coronavirus have been coupled with “sharp” declines in patients seeking care, Reuters reported. Mammogram volume in Austin, for instance, is down roughly 90%, one expert told the news service.

Scientists with the Italian College of Breast Radiologists recently detailed four structured recommendations for keeping imaging safe amid the pandemic, publishing their thoughts Monday in La Radiologia Medica.

“Because of the combination of lockdown, need of social distancing, and reduced hospital resources, in many cases the routine outpatient breast imaging activity has been drastically reduced,” wrote Federica Pediconi, with the University of Rome’s Department of Radiological, Oncological and Pathological Sciences, and colleagues from several other institutions. “Therefore, it is crucial to define which women require urgent or non-reschedulable care, can wait reasonable time, or can wait until the pandemic is over.”

Here are their four tips:

1) Confirmation: Patients with a scheduled or to-be-slated appointment for in-depth diagnostic breast imaging or needle biopsy should confirm the appointment or obtain a new one.

2) Non-deferrable: Those who have suspicious symptoms of breast cancer—such as a palpable new nodule, skin or nipple retraction, orange peel skin, or unilateral secretion—should request a non-deferrable exam.

3) Hold off: Women who are free of symptoms and slated for an annual mammographic follow-up after breast cancer treatment should “preferably” schedule an appointment within a year and three months from the last check. This, of course, is dependent on local availability and resources, the team added.

4) Speed up: Meanwhile, other asymptomatic women who haven’t responded to an invitation for screening since the start of the pandemic—or have been informed of the suspension of services—should reschedule. This would preferably occur within three months from the date of the never-performed check, the authors advised.

As is customary, all imaging should be performed wearing personal protective equipment, utilizing social distancing and with strict sanitation of the equipment and other surfaces. Pediconi and colleagues emphasized that their advice may shift, given COVID-19’s ever-moving target.

“As the pandemic rapidly evolves, we are increasingly learning about viral transmission and its impact on the healthcare system. Thus, these recommendations may change over time and could need to be updated,” the team concluded.

You can read more of their recommendations—including the emotional aspects of cancer care, and PPE tips—in the official journal of the the Italian Society of Medical Radiology here.