Comment on “Response to COVID-19 in Breast Imaging”

We read with great interest the article “Response to COVID-19 in Breast Imaging,” published April 1, 2020 (1). COVID-19 has spread worldwide, with more than 1,000,000 confirmed cases in 207 countries as of April 4, 2020 (2). The measures put in place to combat COVID-19 are impressive, with negative consequences and uncertainty in various health sectors (3). In this situation, it is mandatory to reorganize clinical activity in order to continue providing essential services. The authors of the article highlighted some important key points of managing a breast imaging department during the COVID-19 pandemic (1).

A rapid and unexpected surge of COVID-19 in the northern part of Italy forced our hospital, in Milan, to respond quickly to this event, without any comparison in the western world (4). Our screening activity (12 000 mammograms per year) was suspended on February 24, 2020, reopened on March 2, 2020, and then suspended again on March 9, 2020, following the evidence of the growing infection. Regarding the important recommendations provided, we would like to emphasize the protection of staff and patients through temperature control and the administration of a screening questionnaire; in addition, both staff and patients are provided with a surgical mask to be worn in the hospital.

A breast radiologist and a technologist must always be available for urgent cases: evaluation and sampling of BI-RADS 4 and 5 lesions (5), clinical symptoms, known cancer needing localization, and the extent of disease determination. Moreover, a staff person is always present to answer the phone. A subset that deserves to be better analyzed are BI-RADS 3 patients. As stated by Dr. Plecha and Dr. Leung (1), this category could be rescheduled; in order to do this, we ran a query in the reports from July 2019 to October 2019 for the words “BI-RADS 3” and contacted these patients, who were happy for this initiative.

Understanding that we are facing an unprecedented situation, we underline and support the need for a “standard operating procedure” in the setting of rescheduling exams and case management to avoid unequal attitudes or possible lawsuits.

Conflict of interest statement

None declared.

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