Svati Singla Long, M.D.

Dr. Long is a breast imaging radiologist with Raleigh Radiology in North Carolina.

Although the importance of breast cancer screening should always be emphasized, the current issues surrounding the coronavirus disease 2019 (COVID-19) pandemic have led to a decrease in the number of women who are continuing to follow their usual mammogram schedule.

According to experts, neglecting to have vital cancer screenings puts an individual at a greater risk. Moreover, recent research has shown that, at the onset of the COVID-19 pandemic, nearly 50 percent of the American women who are breast cancer survivors have experienced disruptions in their care, revealing critical flaws in disaster preparedness within the nation’s current healthcare system.

Study Finds Delays in Breast Cancer Treatment During Pandemic

To determine how the COVID-19 pandemic has affected breast cancer survivors' abilities to continue their cancer treatment, two University of Chicago providers created a questionnaire that  focused on the prevalence of the delays that these survivors experienced.

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The questionnaire was distributed to breast cancer survivors in the United States vis email and social media. All total, 608 women, with an average age of 47, and one man responded to the survey. 

Respondents were asked if their appointments were re-scheduled for a later date even after they received a breast cancer diagnosis, as well as which aspects of their care were being delayed. Many patients stated that, rather than having their treatments canceled, they were modified in some way.

Patient-Reported Treatment Delays in Breast Cancer Care During the COVID-19 Pandemic

 study results, approximately 44 percent of responders reported delays in their care with diagnostic imaging tests and follow-up office appointments being the two most frequently postponed services.

Breast Cancer Treatments and Care Negatively Affected

Within the group of responders, 63 percent received cancer treatment, and many reported the pandemic had a negative effect on the care they received:

Nearly 80 percent stated that they had to re-schedule their doctor's office visits (routine).

Almost 70 percent who were scheduled to have reconstruction surgery needed to re-schedule their procedure.

For imaging, 60 percent were re-scheduled.

Fifty percent had to delay their lab tests.

In addition, 30 percent of respondents said they experienced a pause in their therapy at a clinic or hospital: 

Surgery for the removal of a tumor/lump (26 percent)

Consequently, the pandemic has had a serious impact on diagnosing, treating, and researching cancer. And, it is has created a serious cause for concern.

According to Philip Salem, M.D., president of the Salem Oncology Center in the Texas Medical Center, the pandemic has significantly impacted the cancer community. Due to their fears of catching COVID-19, many people are neglecting their cancer screenings.

However, with cancer being much deadlier than COVID-19, the director emeritus of cancer research at Baylor Medical Center said, people actively undergoing cancer treatment, as well as those who need their breast cancer screening, should not fear contracting the COVID-19 virus while at the hospital. Precautions against transmission are being taken.

Multi-disciplinary Recommendations for Treating Breast Cancer During a Pandemic

When considering disaster preparedness, there is a serious gap present in the U.S. healthcare system. This gap has led to the creation of recommendations for treating breast cancer patients during a pandemic.

 outlines the recommendations drafted by a group of expert medical societies, including the American College of Radiology and several other groups, for breast cancer treatment during the current pandemic.

These guidelines are designed to modify patient care in ways that will minimize the risk of exposure to the virus while preserving the resources necessary for treating breast cancer patients that require the most immediate care.

New Recommendations for Prioritizing Patients

This multi-disciplinary group recommends categorizing patients with breast cancer into one of the treatment priority levels (A, B or C):

Patients with symptomatic, life-threatening, completely intolerable or clinically unstable conditions fall within this category. In addition, patients whose prognosis would be altered significantly in the event of a short delay are included in the Priority A category.

This category includes most breast cancer patients. These women are not currently experiencing a life-threatening condition; however, they do require services or treatment in the near future. Care for these patients can be delayed, just not indefinitely.

The overall thought is that, if a geographic location only has enough resources available to accommodate Priority A patients, treatment for Priority B patients can be postponed from six weeks to 12 weeks without a negative impact on the patient’s health.

Certain services and treatments for these patients can be delayed indefinitely without any concerns about negatively affecting the patient’s outcome. To view recommendations for this group in their entirety, 

Overall, following these recommendations will make it easier to treat patients with breast cancer during this pandemic, or any other type of disaster that may arise. By categorizing these patients according to their current condition, medical professionals can provide breast cancer care strategically, undoubtedly saving lives.

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Delays in the diagnosis and treatment of breast cancer have led to the creation of multidisciplinary recommendations for breast cancer care during the COVID-19 pandemic. 

Author | Svati Singla Long, M.D.

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