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

Lycopene: Hepatoprotective and Antioxidant Effects toward Bisphenol A-Induced Toxicity in Female Wistar Rats

Bisphenol A (BPA)—an endocrine disruptor xenoestrogen—is widely spread in the environment. Lycopene (LYC) is an antioxidant phytochemical carotenoid. The hereby study was designed to verify the deleterious effect of BPA on cyclic female rats’ hepatic tissue as well as evaluation of the effect of LYC toward BPA hepatic perturbation. Twenty-eight female Wistar rats were allocated equally into four groups: control group, LYC group (10 mg/kg B.wt), BPA group (10 mg/kg B.wt), and BPA + LYC group (the same doses as former groups). The treatments were given daily via gavage to the rats for 30 days. The rats in BPA displayed high activities of serum liver enzymes with low levels of total proteins (TP) and albumin. Moreover, BPA induced hepatic oxidative stress via depletion of antioxidant enzymes concomitant with augmentation of lipid peroxidation, increased comet tail DNA %, and overexpression of caspase-3. Meanwhile, LYC administration reduced the cytotoxic effects of BPA on hepatic tissue, through improving the liver function biomarkers and oxidant-antioxidant state as well as DNA damage around the control values. These findings were confirmed by hepatic histopathological examination. Finally, LYC credited to have a noticeable protective effect versus BPA provoked oxidative injury and apoptosis of the liver tissue