Bridging pre-surgical endocrine therapy for breast cancer during the COVID-19 pandemic: outcomes from the B-MaP-C study

Rajiv V Dave, Beatrix Elsberger, Vicky P Taxiarchi, Ashu Gandhi, Cliona C Kirwan, Baek Kim, Elizabeth M Camacho, Charlotte E Coles, Ellen Copson, Alona Courtney, Kieran Horgan, Patricia Fairbrother, Chris Holcombe, Jamie J Kirkham, Daniel R Leff, Stuart A McIntosh, Rachel O'Connell, Ricardo Pardo, Shelley Potter, Tim RattayNisha Sharma, Raghavan Vidya, Ramsey I Cutress, B-MaP-C study collaborative

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The B-MaP-C study investigated changes to breast cancer care that were necessitated by the COVID-19 pandemic. Here we present a follow-up analysis of those patients commenced on bridging endocrine therapy (BrET), whilst they were awaiting surgery due to reprioritisation of resources.

This multicentre, multinational cohort study recruited 6045 patients from the UK, Spain and Portugal during the peak pandemic period (Feb–July 2020). Patients on BrET were followed up to investigate the duration of, and response to, BrET. This included changes in tumour size to reflect downstaging potential, and changes in cellular proliferation (Ki67), as a marker of prognosis.

1094 patients were prescribed BrET, over a median period of 53 days (IQR 32–81 days). The majority of patients (95.6%) had strong ER expression (Allred score 7–8/8). Very few patients required expedited surgery, due to lack of response (1.2%) or due to lack of tolerance/compliance (0.8%). There were small reductions in median tumour size after 3 months’ treatment duration; median of 4 mm [IQR − 20, 4]. In a small subset of patients (n = 47), a drop in cellular proliferation (Ki67) occurred in 26 patients (55%), from high (Ki67 ≥ 10%) to low (
This study describes real-world usage of pre-operative endocrine therapy as necessitated by the pandemic. BrET was found to be tolerable and safe. The data support short-term (≤ 3 months) usage of pre-operative endocrine therapy. Longer-term use should be investigated in future trials.
Original languageEnglish
Number of pages15
JournalBreast Cancer Research and Treatment
Early online date03 Apr 2023
Publication statusEarly online date - 03 Apr 2023


  • Neoadjuvant endocrine therapy
  • Breast cancer
  • Bridging endocrine therapy
  • COVID-19


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