The respiratory illness commonly referred to as “coronavirus” and officially called COVID-19 has changed life as we know it.
The Centers for Disease Control and Prevention (CDC) says that the risk of becoming seriously ill from COVID-19 is low for most people. However, it’s very important to know that people who are currently diagnosed with cancer, including breast cancer, have a higher risk of severe illness if they get COVID-19. Having a history of cancer also may increase your risk of severe illness from COVID-19.
Some breast cancer treatments — including chemotherapy, targeted therapies, and immunotherapy — can weaken the immune system and possibly cause lung problems. People who have weakened immune systems or lung problems have a much higher risk of serious complications if they become infected with the coronavirus. For most people, the immune system recovers within a couple of months after completing these breast cancer treatments. But your immune system’s recovery time can vary and depends on several factors. If you’ve received these treatments in the past, it’s not clear if you’re at higher risk of serious complications from COVID-19.
People with breast cancer that has metastasized (spread) to the lungs also can have lung problems that may get worse if they develop COVID-19.
To protect yourself and help reduce the spread of the virus, it’s important to wear a mask that fits snugly when you are around other people, avoid close contact with people outside your household, get vaccinated, and get a booster when and if you can.
If you or a loved one are receiving treatment for breast cancer during the COVID-19 pandemic, here’s what you need to know:
- What is coronavirus?
- Can people with breast cancer get a COVID-19 vaccine?
- How does COVID-19 spread between people?
- What are the symptoms of COVID-19?
- What should I do if I develop COVID-19 symptoms?
- Who is at risk of getting COVID-19?
- How can I protect myself and others?
- Should I wear a face mask?
- Is it safe for breast cancer screening or treatment to be delayed or changed?
- How can I manage anxiety and loneliness while isolating?
- Listen to the latest COVID-19 podcast episodes
What is coronavirus?
Coronaviruses are a large group of viruses that can cause respiratory illness in humans and animals. The coronavirus causing the current pandemic is called SARS-CoV-2, and the illness it causes is called coronavirus disease 2019, which is abbreviated as COVID-19.
The first case was diagnosed in China in December 2019, and it has since spread to almost every country in the world.
Can people with breast cancer get a COVID-19 vaccine?
Yes, the three COVID-19 vaccines available in the United States are considered safe and effective for people receiving treatment for cancer and with a history of cancer in most cases. The CDC, the National Comprehensive Cancer Network (NCCN), and other expert medical groups have recommended that people receiving treatment for cancer should be vaccinated. Still, everyone’s situation is different, and you should talk with your doctor about getting vaccinated and when to get a booster shot.
Learn more about COVID-19 Vaccine Facts for People With Breast Cancer.
How does COVID-19 spread between people?
This virus mostly spreads through close contact with other people (within 6 feet) through droplets of respiratory fluids produced when a person coughs or sneezes. These respiratory droplets can travel through the air and either be inhaled or otherwise get into the noses, mouths, or eyes of people nearby.
The virus spreads easily between people. People become contagious up to two days before developing symptoms. But it’s important to know that many people who become infected don’t develop noticeable symptoms, and you can still catch the virus from them.
Research now shows that new strains of the virus, such as omicron, can live in the air for up to three hours. It’s important to know that health experts are divided on how often the virus spreads through the air, but it could explain why some variants are more contagious.
As doctors have learned more about the virus, the risk of getting infected by touching a contaminated surface and then touching your face seems lower than previously thought. Still, it’s smart to continue frequently washing your hands and not touching your face in public, as well as cleaning and disinfecting doorknobs, countertops, cell phones, and other surfaces you and your family touch every day.
What are the symptoms of COVID-19?
According to the CDC, a wide range of symptoms has been reported for COVID-19, ranging from mild to severe. Symptoms may appear from two to 14 days after you’re exposed to the virus.
People with these common symptoms may have COVID-19:
- shortness of breath or difficulty breathing
- aches and pains
- sore throat
- loss of taste or sense of smell
- nausea or vomiting
- runny nose or congestion
This list doesn’t include all the symptoms that have been linked to COVID-19. Call your doctor if you have other severe symptoms or if you are concerned about symptoms you’re experiencing.
Most people who get COVID-19 have mild respiratory symptoms and can recover at home in about two weeks. However, symptoms can become severe in certain people.
Severe symptoms that require immediate medical attention include:
- difficulty breathing or shortness of breath
- persistent chest pain or pressure
- confusion or inability to awaken
- blueish color in the lips or face
If you or a loved one experiences any of these emergency warning signs, call 911 immediately. People who are older than 60; people who have existing serious health conditions such as cancer, chronic kidney disease, COPD (chronic obstructive pulmonary disease), heart disease, obesity, sickle cell disease, a weakened immune system, or diabetes; and people who smoke appear to have a higher risk of developing severe illness and complications from COVID-19. This includes people who are receiving cancer treatments that can weaken the immune system or cause lung problems and people who have cancer that has spread (metastasized) to the lungs.
Possible complications of COVID-19 include:
- organ failure
What should I do if I develop symptoms?
If you experience fever, cough, or shortness of breath, you should call your doctor. If you or a loved one experiences severe symptoms that can signal an emergency, such as difficulty breathing, persistent chest pain or pressure, confusion or inability to awaken, or blueish color in the lips or face, immediate medical attention is needed and you should call 911. Make sure to tell the 911 operator that you suspect COVID-19 so the responders can take the necessary precautions to protect themselves.
People who experience mild symptoms can usually stay home while the illness runs its course and recover in about two weeks. But if you are receiving treatment for breast cancer, you should definitely let your doctor know.
Two main types of tests can confirm your symptoms are indeed caused by COVID-19. PCR tests are the most accurate and are available free at many local health centers and pharmacies, but it can take hours or days to get your results. Antigen tests are less accurate but you can get the results instantly and perform the test at home. Private health insurance plans are now required to cover the cost of antigen tests, so you may be able to purchase them with no out-of-pocket cost, or pay for them up front (about $10 to $15) and be reimbursed by your insurer. However, antigen tests may be difficult to find because of short supply and high demand. As of Jan. 18, each household in the United States can order up to four rapid test kits via the federally run site COVIDtests.gov.
The U.S. Food and Drug Administration (FDA) recommends that anyone with a suppressed immune system should talk to their doctor about monoclonal antibody treatment options if they’re exposed to the virus.
Monoclonal antibodies are made in a lab and work like the antibodies made naturally by our immune systems. The FDA authorized emergency use of the following monoclonal antibodies to treat COVID-19:
- bamlanivimab and etesevimab, given together
- REGEN-COV (chemical names: casirivimab and imdevimab, given together)
Bamlanivimab and etesevimab are given together as a single IV infusion, which means they’re delivered directly into your bloodstream through an IV or a port. REGEN-COV can be given as an IV infusion or by multiple injections into the skin. Sotrovimab is given as an IV infusion.
The FDA also has authorized emergency use of two additional antiviral medications:
- Pfizer’s Paxlovid (chemical name: nirmatrelvir and ritonavir, co-packaged in pill form) to treat mild-to-moderate COVID-19 in adults and young children ages 12 and older who have tested positive for the virus and are at high risk of serious illness and death from the disease
- Merck’s molnupiravir (taken as a pill) to treat mild-to-moderate COVID-19 in people 18 and older who have tested positive for the virus, are at high risk of serious illness and death from the disease, and who are not eligible for or do not have access to other FDA-authorized COVID-19 treatments
Both Paxlovid and molnupiravir are available by prescription only and should be started as soon as possible after a COVID-19 diagnosis and within five days of initial symptoms.
If you do develop symptoms and need to go a doctor’s office, an urgent care, or an emergency room, call ahead and tell the office you might have COVID-19 and say when you plan to arrive.
If you do become sick, you can take the following steps to protect others:
- stay home, unless you need medical care
- separate yourself from others in your home
- cover your mouth and nose when you cough or sneeze, properly dispose of tissues, and wash your hands
- monitor your symptoms and temperature
- wear a face mask when you're around others; you should also wear a face mask if you are caring for someone who is sick
You should follow these steps until at least five days have passed since you first noticed symptoms, you’ve had no fever for one full day without fever-reducing medicine, and your symptoms have improved. But you should still wear a mask around others for at least another five days. You can also take a test on the fifth day to determine whether you should continue to isolate.
Not everyone needs to be tested for COVID-19. If you develop symptoms, ask your doctor if a test is available and recommended for you.
Who is at risk of getting COVID-19?
The CDC says that most people have a low risk of becoming seriously ill from COVID-19. However, it’s important to understand the difference between your risk of becoming seriously ill if you do become infected versus your risk of being infected in the first place.
While we know that people with a current diagnosis of cancer are at a higher risk of severe illness from COVID-19, research suggests that people diagnosed with cancer may be at higher risk for COVID-19 infection if they are exposed to the virus. This makes it extra important to limit your contact with other people and follow other safety practices such as wearing a mask in public if you have been diagnosed with cancer.
People who currently have a higher risk of becoming infected include:
- those who have not been vaccinated against COVID-19
- those who live in communities where the virus is spreading
- healthcare workers who may be exposed to sick people
- people who require frequent hospital visits for medical care
- those who have had close contact with people who have been infected
- people who have recently traveled to places where the virus is known to have spread
- people who are unable to limit their contact with others
How can I protect myself and others?
The best ways to avoid becoming sick from COVID-19 is to get vaccinated, get a booster if you can, and avoid being exposed to the virus.
Learn more about COVID-19 Vaccine Facts for People with Breast Cancer, including what you can do if you are fully vaccinated.
It’s also important to take other safety precautions to lower your risk of getting sick, especially if you have a serious health problem such as breast cancer. If you are immunocompromised, the CDC recommends asking your doctor whether you should continue wearing a mask that fits snugly in public and avoiding close contact with people you don’t live with, even if you are fully vaccinated.
If you are not vaccinated, you should follow recommended physical distancing practices when possible, including:
- staying at home
- avoiding public spaces
- avoiding public transportation and unnecessary travel
- avoiding social gatherings
- working from home
- staying at least 6 feet away from people when out in public
- avoiding physical contact such as handshakes, hugs, and kisses in social situations
- avoiding contact with people who are or may be sick
Here are some additional precautions to take if you're unvaccinated:
- Wash your hands frequently using soap and water for at least 20 seconds, especially after being out in public, coughing, sneezing, or blowing your nose.
- Use alcohol-based hand sanitizer with at least 60% alcohol when soap and water aren’t available.
- Don’t touch your face when your hands aren’t clean, and make it a habit to not touch your face when you’re outside your home.
- Wear a face mask when in public places (but make sure you do this safely).
- Practice healthy habits: eat well, exercise, avoid or limit alcohol, don’t smoke or vape, and get enough sleep.
- Switch to glasses if you wear contact lenses to avoid touching your eyes more than necessary, or follow proper contact lens hygiene.
If you are receiving treatment for breast cancer, are immunocompromised, or are living with breast cancer that has metastasized (spread) to the lungs, the following extra precautions may help you protect yourself:
- be extra vigilant about hand hygiene and not touching your face
- avoid close contact with friends and family and take precautions if you depend on them for medical care
- make a plan with your doctor to monitor for symptoms
- make a plan with your caregiver or other loved ones in case you or they get sick
- make a plan with your employer to work from home if you’re not already doing so
- stock up on medications
- ask a friend or family member to shop for groceries or pick up medications for you
If you need to visit a healthcare facility for your medical care, all staff members and patients should be wearing masks and practicing physical distancing. It’s also OK to ask healthcare providers and caregivers to wash their hands before touching you. And it’s a good idea to talk to your oncologist about any other protective measures that may be recommended for your unique situation.
Because this is a continually changing situation, it’s wise to pay attention to the CDC’s updates to continue assessing the risks in your area.
Should I wear a face mask?
Since the beginning of the pandemic, the CDC has issued evolving recommendations on wearing a face mask. The recommendations are based on the number of people vaccinated, as well as how contagious the current COVID-19 strains are.
Current recommendations are that fully vaccinated people should wear masks in indoor public settings if they live in areas where COVID-19 is spreading at “substantial” or “high” levels. This CDC tool shows you whether COVID-19 is spreading at low, moderate, substantial, or high levels where you live.
All unvaccinated people should wear a mask in public indoor and outdoor settings.
The CDC also recommends that everyone should wear masks in schools. Additionally, the CDC says that all fully vaccinated people might want to wear a mask in public indoor settings for extra protection, especially if they have a weakened immune system or live with someone who has a weakened immune system or a higher risk of severe illness from COVID-19. If you’re immunocompromised, the CDC recommends that you talk to your doctor about taking extra precautions, even if you are fully vaccinated and have received a booster.
If you know someone who is immunocompromised or has a medical condition, such as cancer, that puts them at higher risk for severe complications from COVID-19, it’s a good idea to wear a mask when you visit them indoors, even if you both are fully vaccinated and have received boosters.
If you have been fully vaccinated and have received a booster for COVID-19, the CDC still recommends that you wear a mask in places where masks are required (such as businesses, hospitals, correctional facilities, homeless shelters, and when traveling on planes, buses, trains, and other types of public transportation).
Health experts have said that wearing cloth masks alone is not enough to protect people from new, more contagious strains of the virus, such as omicron.
These experts urge people to wear either an N95 mask or a KN95 mask, especially in crowded places. These masks form a seal around the nose and mouth, which results in a better fit and keeps the mask from sliding down when you talk. These masks also are made with materials that prevent tiny particles from getting into your nose and mouth. If getting these types of masks is challenging, health experts recommend wearing a three-ply surgical mask with a cloth mask on top of it, rather than wearing a cloth mask alone.
Make sure you buy N95 or KN95 masks from a seller with a good reputation, as there have been scammers selling fake versions that may offer less protection. Many healthcare providers recommend Projectn95.org as a trustworthy non-profit resource for ordering masks and COVID-19 tests.
Is it safe for breast cancer screening or treatment to be delayed or changed?
At the beginning of the pandemic, many hospitals and other healthcare facilities delayed or canceled elective procedures, meaning screenings, surgeries, and other treatments that were not considered urgent, emergencies, or otherwise indicated for life-threatening conditions. This was distressing if it happened to you or a loved one — if you were scheduled to have a cancer screening, surgery, or other treatment, you probably felt that it was urgent. But these tough decisions were made to help protect people from the risk of getting COVID-19 in a healthcare facility and to make sure healthcare providers had the resources they needed to treat people with severe cases of COVID-19.
Most radiology and imaging centers are offering routine mammograms again. So, if your annual mammogram was delayed, you should reschedule as soon as possible. Routine screenings are different from tests performed on people with cancer symptoms — if you have symptoms, you should tell your doctor and follow their recommendations for next steps.
Doctors are looking at each person’s unique situation and diagnosis when deciding how to best move forward with breast cancer treatment during the pandemic. For example, they are looking at whether a person has a higher risk of becoming seriously ill from a COVID-19 infection due to a weakened immune system from treatments such as chemotherapy or targeted therapy, or because of their age or other health problems.
Healthcare facilities have adopted stricter safety practices to reduce the risk of exposing people to COVID-19. At the same time, many cancer treatment plans have been changed so people don’t have to spend as much time at these facilities. Medical appointments are being spread out to avoid close contact between people, more appointments are being done over the phone or online, and hospital stays after surgery have been shortened. In some cases, fewer in-person visits are required to complete chemotherapy or radiation therapy.
Talk to your doctor about the best way to proceed to make sure you can get the best care possible in this challenging situation. You may be able to see healthcare providers virtually for certain appointments through telemedicine (by phone or internet video).
Read more about how the pandemic affected breast cancer treatment in our Special Report: COVID-19’s Impact on Breast Cancer Care.
How can I manage anxiety and loneliness while isolating?
Limiting your contact with others is critically important for protecting yourself and lowering your risk of getting COVID-19. But long-term physical distancing is not easy and can lead to feelings of anxiety, depression, and loneliness. If you’re experiencing these feelings while isolating at home, you are not alone — so many of us are going through it with you.
Fortunately, there are plenty of things we can do to manage these feelings and stay connected with our loved ones. Here are some tips from licensed clinical social worker Kelly Grosklags on how to manage the loneliness or anxiety you might be feeling while having to practice physical distancing because of COVID-19:
- Use social media and electronic tools such as FaceTime, Zoom, Google Hangouts, messaging apps, and texts to stay in touch with loved ones.
- Start a virtual book club with your friends.
- If you don’t have internet access or have limited access, phone calls are also a great way to keep in touch.
- Consider writing letters to people with dementia who are in care facilities and may not be able to work a phone.
- Take up a new hobby: knitting, jigsaw puzzles, crossword puzzles. Learning something new can take your mind off the COVID-19 situation for a little while.
- Many museums, aquariums, and zoos are giving people online access to their resources. Soothe yourself with some beautiful artwork or some waddling penguins.
- Above all, remember to breathe and live in the now. Living in the past can make you depressed. Living in the future can make you fearful. Live in the now and practice gratitude for the good things in your life.
Listen to the latest COVID-19 podcast episodes
Hear from experts about issues related to COVID-19 that are important to people with breast cancer:
American Rescue Plan: Benefits for the Breast Cancer Community, with Joanna Fawzy Morales, Esq.
Update on COVID-19 Vaccines, with Halle Moore, M.D.
Understanding the COVID-19 Vaccines, with Hana El Sahly, M.D.
Weslinne’s Story: Diagnosed With Breast Cancer During COVID-19, with Weslinne Cespedes
Flu Vaccines and Holiday Safety During the COVID-19 Pandemic, with Elizabeth Robilotti, M.D.
COVID-19 Testing Confusion, with Megan Kruse, M.D.
COVID-19 and Breast Cancer Care: Follow-Up Questions, with Brian Wojciechowski, M.D.
Quarantine Fatigue: How to Stay Vigilant About Your Safety During the COVID-19 Pandemic, with Jackie Gollan, M.D.
COVID-19 and Metastatic Breast Cancer, with Shirley Mertz, chair, Metastatic Breast Cancer Alliance
Update: Breast Surgery and Reconstruction During COVID-19, with Julie Sprunt, M.D., FACS, and Elisabeth Potter, M.D.
COVID-19 Insurance and Financial Issues for People With Breast Cancer, with Joanna Morales, Esq, CEO, Triage Cancer
Staying Active During Quarantine: Tips for People With Breast Cancer, with Sami Mansfield, cancer exercise specialist
Breast Surgery and Reconstruction During COVID-19, with Julie Sprunt, M.D., FACS, and Elisabeth Potter, M.D.
COVID-19 and Breast Cancer Treatment, with Brian Wojciechowski, M.D.
Managing Loneliness and Anxiety During This Time of Social Distancing, with Kelly Grosklags, LICSW, BCD, FAAGC
COVID-19: What We Know Now, with Angela Rasmussen, Ph.D.
Adam Leitenberger, editorial director
Jamie DePolo, senior editor
Vivian Lee, assistant editor
This content was developed with contributions from the following experts:
Halle Moore, M.D., director of breast oncology, Cleveland Clinic
Marisa Weiss, M.D., chief medical officer
Brian S. Wojciechowski, M.D., medical adviser
World Health Organization COVID-19 pages: https://www.who.int/emergencies/diseases/novel-coronavirus-2019
U.S. Centers for Disease Control and Prevention COVID-19 pages: https://www.cdc.gov/coronavirus/2019-ncov/index.html
American Society of Clinical Oncology COVID-19 Patient Care Information: https://www.asco.org/asco-coronavirus-information/care-individuals-cancer-during-covid-19
Johns Hopkins Coronavirus Resources Center: https://coronavirus.jhu.edu/map.html
Harvard Health Publishing Coronavirus Resource Center: https://www.health.harvard.edu/diseases-and-conditions/coronavirus-resource-center
Science Magazine Coronavirus Research, Commentary and News: https://www.sciencemag.org/coronavirus-research-commentary-and-news
New England Journal of Medicine COVID-19 page: https://www.nejm.org/coronavirus
National Comprehensive Cancer Center Network COVID-19 Resources: https://www.nccn.org/covid-19/
American Society for Radiation Oncology Recommendations and Information: https://www.astro.org/Daily-Practice/COVID-19-Recommendations-and-Information
American Society of Breast Surgeons Recommendations on Treatment During COVID-19 Pandemic: https://www.breastsurgeons.org/docs/news/The_COVID-19_Pandemic_Breast_Cancer_Consortium_Recommendations_EXECUTIVE_SUMMARY.pdf?01
American Society of Plastic Surgeons Statement on Breast Reconstruction During COVID-19 Pandemic: https://www.plasticsurgery.org/documents/medical-professionals/COVID19-Breast-Reconstruction-Statement.pdf
This special content made possible in part through generous support from AstraZeneca; Daiichi Sankyo; Eisai; Genentech; Lilly Oncology; Pfizer; Seattle Genetics; an independent educational grant from Merck & Co., Inc.; and individuals like you.