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Survey Suggests COVID-19 Pandemic Led to Delays in Care for Nearly Half of Breast Cancer Survivors

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The early weeks of the COVID-19 pandemic caused 44% of breast cancer survivors to have a delay in care, according to an online survey.

The research was published online on Aug. 9, 2020, by the journal Breast Cancer Research and Treatment. Read "Patient-reported treatment delays in breast cancer care during the COVID-19 pandemic."

COVID-19 and breast cancer

Coronaviruses are a large group of viruses that can cause respiratory illness in humans and animals. The coronavirus we’ve all heard so much about is called SARS-CoV-2, and the illness it causes is called coronavirus disease 2019, which is abbreviated as COVID-19.

The virus that causes COVID-19 is very, very contagious — about 3 times as contagious as the flu virus. It spreads mainly through droplets of fluid produced when a person coughs or sneezes. People who are within 6 feet of an infected person may then inhale or otherwise get the droplets into their noses, mouths, or eyes.

To date, there is no vaccine or completely effective treatment for COVID-19.

Because COVID-19 is so contagious, and to save healthcare resources for people diagnosed with COVID-19, many hospitals and other healthcare facilities delayed or cancelled elective procedures beginning in March 2020. Elective procedures included anything that didn’t need to be done to save someone’s life. Breast cancer screening was considered an elective procedure, so many mammograms were delayed or cancelled. Some breast cancer surgeries and other treatments also were delayed, changed, or cancelled.

COVID-19 did not hit the United States evenly. Some states reported thousands of cases, while others reported only a few hundred. So delays in breast cancer care were different in different places.

The researchers from the University of Illinois Chicago who did this study wanted to see how changes in healthcare due to the pandemic affected people who had been treated for breast cancer.

About the study

The researchers wrote a 50-question online survey to figure out how the COVID-19 pandemic had affected breast cancer care. The researchers invited adults who had been diagnosed with breast cancer to complete the survey by sending invitations via email, posting on social media, and sending invitations to breast cancer support networks.

From April 2-27, 2020, 609 people completed the survey. The respondents’ characteristics:

  • 608 were women, 1 was a man
  • average age was about 48 years
  • average age at breast cancer diagnosis was 43
  • 46% of the people were within 5 years of their most recent diagnosis
  • 78% were white, 17% were Black, 3% were Asian
  • 15% lived in Illinois, 9% lived in California, 8% lived in Texas
  • 63% were being treated for cancer when they completed the survey
  • 67% had employer-sponsored health insurance
  • 45% were being treated at an academic medical center, 26% at a doctor’s office, 21% at a community hospital

The results showed that 44% of the respondents answered "yes" to the question: "Has any aspect of your cancer care been delayed or interrupted due to the COVID-19 pandemic?"

Reports of delays were slightly higher for white and Asian respondents compared to Black respondents.

People who were younger reported more delays than people who were older.

Delays in a routine or follow-up doctor appointment were the most common, followed by delays in breast reconstruction surgery and diagnostic imaging or testing.

About 30% of the respondents said they had a delay in treatment, including radiation, infusions, and surgery to remove the cancer.

"We expected the usual racial difference we see in health care, with Black patients being disproportionately affected, but our results showed that patients were universally affected by COVID in terms of delays in breast cancer care, likely because in those early weeks, hospitals and health care facilities were postponing visits and procedures across the board as they took on the growing burden of dealing with COVID-19," said co-author Tamara Hamlish, Ph.D., research scientist in the cancer survivorship program at the University of Illinois Cancer Center, in a statement.

"We were surprised to see that younger women were more likely to experience delays, and we think that has to do with cancellations of hormone therapy for ovarian suppression that is given to women with certain types of breast cancer, and those women tend to be younger in general," added co-author Elizabeth Papautsky, Ph.D., assistant professor of biomedical and health information sciences at the University of Illinois.

What this means for you

When the COVID-19 pandemic first started, many medical procedures considered non-urgent were delayed or cancelled. This was primarily for two reasons:

  • to save medical resources, including doctors’ and technicians’ time, personal protective equipment, medicines, and emergency room and intensive care unit beds, for people who were infected with COVID-19
  • to help reduce the risk of people becoming infected with COVID-19 by keeping them out of hospitals and other care facilities where COVID-19 patients were being treated

As time has passed, doctors have seen how protective procedures, such as wearing a face mask, washing your hands, maintaining physical distancing, and avoiding gathering with people in a group, have helped slow the spread of the virus. So most facilities are once again offering all aspects of breast cancer care, including screening.

If you’re concerned about COVID-19, it makes sense to ask what steps are being taken to protect you from the virus. Many facilities have hotlines you can call. It also makes sense for you to take steps on your own to protect yourself from COVID-19, including:

  • not touching your face while you are at the facility
  • wearing a face mask
  • using hand sanitizer when you leave the facility
  • washing your hands as soon as you get home

For more information, read Breastcancer.org’s Special Report: COVID-19’s Impact on Breast Cancer Care.

Written by: Jamie DePolo, senior editor

Reviewed by: Brian Wojciechowski, M.D., medical adviser


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