Breast cancer management pathways during the COVID-19 pandemic: outcomes from the UK ‘Alert Level 4’ phase of the B-MaP-C study

Abstract: Background: The B-MaP-C study aimed to determine alterations to breast cancer (BC) management during the peak transmission period of the UK COVID-19 pandemic and the potential impact of these treatment decisions. Methods: This was a national cohort study of patients with early BC undergoing multidisciplinary team (MDT)-guided treatment recommendations during the pandemic, designated ‘standard’ or ‘COVID-altered’, in the preoperative, operative and post-operative setting. Findings: Of 3776 patients (from 64 UK units) in the study, 2246 (59%) had ‘COVID-altered’ management. ‘Bridging’ endocrine therapy was used (n = 951) where theatre capacity was reduced. There was increasing access to COVID-19 low-risk theatres during the study period (59%). In line with national guidance, immediate breast reconstruction was avoided (n = 299). Where adjuvant chemotherapy was omitted (n = 81), the median benefit was only 3% (IQR 2–9%) using ‘NHS Predict’. There was the rapid adoption of new evidence-based hypofractionated radiotherapy (n = 781, from 46 units). Only 14 patients (1%) tested positive for SARS-CoV-2 during their treatment journey. Conclusions: The majority of ‘COVID-altered’ management decisions were largely in line with pre-COVID evidence-based guidelines, implying that breast cancer survival outcomes are unlikely to be negatively impacted by the pandemic. However, in this study, the potential impact of delays to BC presentation or diagnosis remains unknown

Views and Descriptions of cyclopian, or, pelasgic remains, in Greece and Italy; with constructions of a later period; from drawings by the late Edward Dodwell, Esq. F.S.A. and member of several foreign academies: intended as a supplement to his "Classica

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Views in Greece from drawings by Edward Dodwell, ESQ. F.S.

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A Classical and Topographical Tour through Greece, during the years 1801, 1805, and 1806.

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La Grèce, ou description topographique de la Livadie, de la Morée et de l'Archipel, contenant des details curieux sur les moeurs et usages des habitants et des contrées (.) ornée d'une carte de la Grèce et de huit vues d'après Dodwell

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L'Érechthéion sur l'Acropole d'Athènes : Athènes (Grèce)

Views in Greece , 1822Le respect des "ordres" architecturaux classiques n'empêche pas les Grecs d'innover. Sur la colline de l'Acropole, un curieux petit temple se démarque par ses colonnes, ni dorique, ni ionique, ni corinthienne. Ce sont des statues de jeunes femmes qui soutiennent l'entablement de la tribune de l'Érechthéion. Ces cariatides connaîtront une large postérité en architecture. Dans le Paris du XIXe siècle, lors du chantier haussmannien, les immeubles les plus cossus sont souvent ornés de ces figures féminines (cariatides) ou masculines (atlantes).téléchargeabl