COVID-19: What People Diagnosed With Breast Cancer Need To Know
Since COVID-19 was first identified, the virus has been an added source of stress for many people diagnosed with breast cancer and their loved ones. People with weakened immune systems and certain other conditions are at higher risk for serious illness from COVID-19. But not everyone with a history of breast cancer is at risk for severe COVID, so it’s important to talk with your doctors about your individual situation.
Here’s what you need to know about COVID-19 vaccines, treatments, prevention strategies, and more.
Which factors could put me at higher risk for severe COVID-19?
If you’ve been diagnosed with breast cancer, there are several factors that can increase your risk of getting severely ill from COVID-19 — even if you are up to date on your COVID-19 vaccines and boosters.
People who have been diagnosed with breast cancer may be taking medicines that weaken their immune system. Breast cancer treatments that can weaken the immune system include:
all standard chemotherapy medicines, such as Taxol (chemical name: paclitaxel), Taxotere (chemical name: docetaxel), Cytoxan (chemical name: cyclophosphamide), and carboplatin
certain targeted therapies, such as Ibrance (chemical name: palbociclib), Kisqali (chemical name: ribociclib), Verzenio (chemical name: abemaciclib), and Piqray (chemical name: alpelisib)
high-dose corticosteroids (if taken for two or more weeks)
surgery
The time it takes the immune system to recover after receiving these treatments varies. If you are receiving treatments that can weaken your immune system or have received them in the past, ask your doctor how long it may take for your immune system to recover.
In rare cases, some people develop lung problems as a side effect of some chemotherapy medicines and targeted therapies. This can put them at higher risk for severe COVID-19 symptoms.
Rare but severe lung inflammation has been linked to certain targeted therapy medicines, including:
Kisqali
Verzenio
Piqray
Enhertu (chemical name: fam-trastuzumab-deruxtecan-nxki)
Lynparza (chemical name: olaparib)
Afinitor (chemical name: everolimus)
Herceptin (chemical name: trastuzumab)
Phesgo (chemical name: pertuzumab, trastuzumab, and hyaluronidase-zzxf)
Kadcyla (chemical name: T-DM1 or ado-trastuzumab emtansine)
The immunotherapy drugs Tecentriq (chemical name: atezolizumab), Keytruda (chemical name: pembrolizumab), and Jemperli (chemical name: dostarlimab-gxly) also may cause lung inflammation.
People with metastatic breast cancer in the lungs can have lung problems that may get worse if they develop COVID-19.
The risk of becoming seriously ill from COVID-19 is higher for people who are 50 and older and risk increases as you get older.
People who have certain other conditions or disabilities such as chronic lung diseases (including COPD or moderate-to-severe or uncontrolled asthma), heart disease, diabetes, and chronic kidney disease are at higher risk for severe COVID-19. Smoking or being overweight or obese also increases risk.
People who have never been vaccinated against COVID-19 or haven’t stayed up to date on COVID-19 vaccines and boosters are at higher risk.
Since each person’s situation is unique, it’s best to talk with your doctors about any factors that might put you at higher risk and which precautions you should consider taking.
Does having a history of breast cancer increase my risk (even if I’m no longer receiving treatment)?
Whether you’re at higher risk for serious illness from COVID-19 depends mainly on the factors listed above.
If your treatment for breast cancer ended years or even months ago, or didn’t include therapies that weaken the immune system, you may not be immunocompromised. Most people who have received breast cancer treatment in the past are not immunocompromised because of them.
Again, it’s best to talk with your doctors about your medical history, individual risk factors, and which precautions make the most sense for you.
Are COVID-19 vaccines safe for people with breast cancer?
The Centers for Disease Control and Prevention (CDC), the National Comprehensive Cancer Network (NCCN), and other expert medical groups recommend that people receiving cancer treatment or who have a history of cancer should get the updated Pfizer-BioNTech or Moderna COVID-19 vaccine to be up to date. COVID-19 vaccines are safe and effective for people in active cancer treatment and active survivorship. The vaccines have been shown to help lower the risk of getting infected with COVID-19 and of being hospitalized with or dying from COVID-19.
If you have a weakened immune system because of breast cancer treatments or other factors, your immune response to COVID-19 vaccines may not be as strong. People who are moderately or severely immunocompromised may get additional doses of the updated Pfizer or Moderna vaccine. To learn more, read the CDC’s recommendations on staying up to date with COVID-19 vaccines.
Which treatments are available for COVID-19?
There are three antiviral medicines available for people who test positive for COVID-19 and are more likely to get very sick from the virus because they are immunocompromised or have other risk factors. These treatments reduce the risk of hospitalization and death from the virus and may reduce the risk of developing long COVID-19.
It’s important to contact a healthcare provider right away if you test positive for COVID-19 to see if you’re eligible for these medicines. If you are receiving breast cancer treatment, be sure to let your cancer care team (and not just your other healthcare providers) know about your positive result.
These COVID-19 treatments are only available by prescription. You must start taking these antiviral medicines within days of when you first develop symptoms for them to be effective. If you are taking other medicines, check with your doctor or pharmacist to see if it’s safe for you to take the COVID-19 treatments at the same time.
If you test positive for COVID-19 while you are receiving breast cancer treatment, your doctor may need to pause or modify your cancer treatment plan while you take medicine to clear the virus. The three antiviral medicines for COVID-19 are:
Paxlovid (chemical name: nirmatrelvir and ritonavir): taken at home by mouth. It should be started as soon as possible after testing positive for COVID-19 and within five days of when symptoms start.
Lagevrio (chemical name: molnupiravir) is taken at home by mouth. It’s for people who are not eligible for or do not have access to other FDA-authorized COVID-19 treatments. It should be started as soon as possible after testing positive for COVID-19 and within five days of when symptoms start.
Veklury (chemical name: remdesivir) is given by IV infusion at a healthcare facility over the course of multiple consecutive days (ranging from three to ten days). It should be started as soon as possible after testing positive for COVID-19 and within seven days of when symptoms start. If you’re not hospitalized because of mild to moderate COVID-19, you might receive Veklury if you have a high risk of the disease becoming severe.
To learn more, read the National Institutes of Health’s guidelines for treating COVID-19, which are updated regularly.
How can I protect myself and others from COVID-19?
Staying up to date on COVID-19 vaccines is one of the best ways to lower the risk of being infected and infecting others. Experts recommend that people who are immunocompromised or have a higher risk for serious illness from COVID-19, along with their loved ones and caregivers, consider additional precautions, even if they’re fully vaccinated:
Wear a mask that fits snugly over your mouth, nose, and chin, especially when you’re in public indoor settings or traveling on public transportation. NIOSH-approved N95 respirators (approved by the National Institute for Occupational Safety and Health) are more protective than cloth masks or disposable surgical masks. Many healthcare providers recommend Projectn95.org as a trustworthy non-profit resource for ordering masks.
Avoid crowds and poorly ventilated indoor spaces.
Avoid contact with people who are or may be sick. If you are meeting with people from outside your household, ask them to get tested for COVID-19 beforehand. And make sure they know to stay home if they have tested positive for the virus, have any COVID-19 symptoms, or might have been exposed to someone who has the virus.
When gathering indoors with people from outside your household, try to improve the ventilation as much as possible by opening windows and doors, using air purifiers, and turning on fans.
Wash your hands frequently with soap and water for at least 20 seconds or use a hand sanitizer that contains at least 60% alcohol, particularly after being out in public.
Get tested for COVID-19 if you have symptoms of an infection or think you have been exposed to the virus. If you have symptoms, you should get tested as soon as possible. If you think you were exposed but do not have symptoms, wait at least five days after exposure before testing. (If you test too early, you are more likely to get an inaccurate result).
Practice healthy habits: eat well, exercise, avoid or limit alcohol, don’t smoke or vape, and get enough sleep.
How can I manage anxiety and loneliness during times that I’m isolating from other people?
Many people have struggled emotionally during the time of COVID-19 because they feel isolated and uncertain about the future.
Breastcancer.org has resources to help you take care of your mental health and connect you with others who are going through similar experiences:
Visit our online community forum to discuss the effects of COVID-19 with other people affected by breast cancer or join one of our Zoom meetups.
Read tips for coping with anxiety and isolation from Breastcancer.org community members.
Listen to our podcasts about how immunocompromised people can continue to protect themselves despite looser COVID-19 restrictions and about how therapy can help people diagnosed with breast cancer.
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.
— Last updated on August 25, 2023 at 4:24 PM