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

Palestinian society : contemporary realities and trends

Arabic version available in IDRC Digital Librar

Palestinian society : contemporary realities and trends [Arabic version]

English version available in IDRC Digital Librar

THE “WOMEN'S FRONT”

Nationalisms are polymorphous and often internally contradictory, unleashing emancipatory as well as repressive ideas and forces. This article explores the ideologies and mobilization strategies of two organizations over a 10-year period in the occupied Palestinian territories: a leftist-nationalist party in which women became unusually powerful and its affiliated and remarkably successful nationalist-feminist women's organization. Two factors allowed women to become powerful and facilitated a fruitful coexistence between nationalism and feminism: (1) a commitment to a variant of modernist ideology that was marked by grassroots as opposed to military mobilization and (2) a concern with proving the cultural worth of Palestinian society to the West, a project that was symbolized by women's status in important ways. By comparing international and indigenous feminist discourses, the study also demonstrates how narratives about gender status in the Third World are implicated in, and inextricable from, international economic and political inequalities.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66822/2/10.1177_089124398012004005.pd