How Has COVID-19 Impacted Breast Cancer Care?

The COVID-19 pandemic is the biggest crisis breast cancer has faced in decades, says a study done by Breast Cancer Now (BCN). The study, based on the answers from 2,124 breast cancer patients in the UK, found that 41 percent of participants felt they had less contact with their regular clinical specialist. Moreover, screening services dropped by 70 percent by the beginning of the pandemic. “A significant backlog of nearly a million women requiring screening has built up across the UK during the pause,” says the study.

Of the study participants, 1,545 had primary breast cancer and 472 had secondary breast cancer, also known as advanced, stage four or metastatic breast cancer. While the survey was conducted in the UK, these figures paint a starting picture of the impact of the pandemic since the UK National Health Service (NHS) is ranked among the best healthcare systems in the world.

The study found that treatment within 31 days of the initial diagnosis dropped by 97 percent during February, March and April, by 90 percent in May and by 95 percent in July. Initially, treatments had to be paused due to the vulnerability of cancer patients to the SARS-CoV-2 virus. According to the NHS, in April, “the number of people starting chemotherapy for breast cancer fell to 61 percent of levels in April 2019. By June this had returned to 92 percent of 2019 levels.”

Breast cancer surgeries were also affected. While 43 percent of the patients pending surgery saw no change on their timeline, 27 percent did face cancellations or delays in their surgery. Moreover, breast reconstruction has been completely suspended during the COVID-19 outbreak. BCN estimated that “over 1,000 women will have missed out on immediate reconstruction and around another 500 will have had their delayed reconstruction delayed further.”

Drug treatment was also disrupted, as 12 percent of patients experienced delays in receiving medicines, 9 percent received the drug in a different setting (at home instead of in a hospital) and 7 percent had a change in their drug prescription, which generated negative emotional impacts on their mental well-being. The study found that 56 percent of the patients did not suffer a change in their drug treatment.

Bisphosphonate treatments, common for post-menopausal patients, showed no delays for the majority of patients while 29 percent saw delays. Of the patients that were going through radiotherapy sessions (which consist of 15 doses five days a week for three weeks), 31 percent of them had a schedule disruption, 10 percent a dosage change and 12 percent had to delay the start of the process.

Mexico does not have figures that reflect COVID-19’s impact, yet. However, according to the Ministry of Health, the diagnosis of breast cancer had dropped by 10 percent in March in comparison to the same month in 2019. By June, the figure had fallen to a 20 percent year-on-year decrease. Cancer is a long-time burden for the Mexican healthcare system and breast cancer is the most frequent one in the country, according to INCan, which reports 27,500 new cases every year and 7,000 deaths.