Objective: During the recent pandemic of COVID-19, apposite planning is necessary to maintain health system resources. Cancer patients are susceptible to COVID-19, but accurate cancer management should be carried out.  As breast cancer is the most common female cancer in Iran, and surgery is the main treatment, we carried out this study to provide the best recommendations for breast surgery and care during the outbreak of COVID-19 in Iran.

Materials and Methods: As cancer and breast surgeons at Cancer Institute of Iran, based on our personal and institutional experience and recently released guidelines, we defined the main headings about breast surgery issues during the outbreak. We investigated the present literature and then discussed each issue.

Results: The best agreed recommendations were delineated. Briefly, telemedicine should be prioritized over in-hospital presence of patients. Visits should be postponed except for cancer workups and treatments, or cases suspicious for cancer. Appropriate protective, preventive, and instructive measures related to COVID-19 should be observed in the outpatient and inpatient Departments for patients, companions, and health care providers. Staging procedures should be minimized. Surgery for non-malignant lesions, reconstructive and cosmetic surgery should be postponed. When breast cancer surgery can be substituted by non-operative treatments without impairing prognosis or quality of life, it should be deferred. Surgeries with lower complication rates and length of stay are favored.

Conclusions: At the time of COVID-19 epidemic, surgery should be performed for breast cancer only if this modality is more advantageous than other therapies in terms of disease outcome and is worth the increased risk of transmission of COVID-19. Otherwise, it should be deferred until control of the epidemic.