CORONAVIRUS (COVID-19) AND BREAST CANCER

Am I at risk of getting coronavirus?

People who are older or who have other health conditions such as heart disease, lung disease or diabetes, are at greater risk of severe illness and death from COVID-19.

If you have breast cancer and are on chemotherapy or immunotherapy, or you have metastatic breast cancer, your immune system may be weakened. This means you have an increased risk of getting sick from COVID-19.

Check the CDC website and your local public health department website for the latest information.

What are the symptoms of COVID-19?

Common symptoms of COVID-19 are:

  • Fever
  • Cough
  • Shortness of breath

Some hospitals are also screening for runny nose/nasal congestion, muscle aches and sudden loss of smell or taste.

These symptoms tend to appear 2-14 days after exposure to coronavirus. However, a person may be contagious before symptoms appear.

If you have symptoms or have been in contact with someone who’s been diagnosed with COVID-19, call your doctor.

For more information on the symptoms of COVID-19 and when to seek medical attention for symptoms immediately, visit the CDC website.

What can I do to protect myself and my family?

To avoid being exposed to coronavirus, the CDC recommends you:

  • Wash your hands often with soap and water for at least 20 seconds. This is especially important after going to the bathroom, before eating, before touching your face, and after blowing your nose, coughing or sneezing. If soap and water are not available, use hand sanitizer.
  • Stay home as much as possible.
  • Avoid contact with people who are sick.
  • Avoid crowds.
  • Avoid touching your eyes, nose, and mouth.
  • Stay home when you are sick. Cover your cough with your elbow or sleeve. Sneeze into a tissue and throw the tissue in the trash.
  • Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.

Will my breast cancer surgery be postponed?

Maybe. Hospitals have limited resources and staff and this is causing some surgeries and other procedures to be postponed. You may hear the term “elective surgery.” This doesn’t mean your surgery isn’t important. It just means it’s not urgent or life-threatening.

If you’re newly diagnosed with breast cancer and your breast surgery is postponed, it doesn’t mean you won’t get treatment right away. Your treatment may begin with chemotherapy or hormone therapy instead of surgery.

Increased use of neoadjuvant (before surgery) therapy

Many people already get chemotherapy or hormone therapy before breast surgery. This is called neoadjuvant therapy. If you will need chemotherapy for your treatment, whether you get it before or after surgery doesn’t impact your survival.

Neoadjuvant therapy is usually given to increase surgical options. If you have a large tumor, neoadjuvant therapy may shrink the tumor enough that a lumpectomy becomes an option to a mastectomy.

More people will now be getting neoadjuvant therapy. For example, if you will need chemotherapy after surgery, your doctor may postpone your surgery and start you on neoadjuvant chemotherapy [1].

Some women with very small estrogen receptor-positive breast cancers who will not need chemotherapy may get neoadjuvant hormone therapy for a period of time [1]. Only some of the hormone therapy will be taken before surgery. Most will be taken after surgery.

Remember, survival is the same whether you get neoadjuvant therapy or you get chemotherapy or hormone therapy after surgery. And, neoadjuvant therapy may increase the chance you can have a lumpectomy instead of a mastectomy.

When is it unlikely my surgery will be postponed?

If you have an aggressive breast cancer, your surgery will not likely be delayed. For example, if you have triple negative breast cancer and have completed neoadjuvant therapy, your surgery will not likely be postponed.

What about breast reconstruction?

Some breast reconstruction surgeries are being postponed due to limited resources and staff. Whether or not your reconstruction is postponed depends on your hospital, your plastic surgeon and sometimes, the type of reconstruction you’re having [1].

Can I go to my breast cancer treatments and doctor appointments during ‘stay at home’ or ‘shelter in place’ orders?

Yes. Getting medical care is an essential service and is not affected by social distancing or shelter in place orders.

Some in-person doctor appointments are being changed to phone or video consults.

Some doctors’ offices are making changes to allow for social distancing. For example, they may spread out appointments so fewer people are in the waiting area at the same time. This may cause a doctor’s appointment to be changed to a different day or time.

During this crisis, some routine appointments like annual mammograms and check-in visits may be postponed.

What if I’m undergoing radiation therapy?

If you’ve already started radiation therapy, your treatment should continue [1].

If you haven’t already started radiation therapy, your treatment may be postponed [1].

For some older women and some women with ductal carcinoma in situ (DCIS), survival is the same with or without radiation therapy [1-4]. So, these women may have radiation therapy removed from their treatment plans [1].

What if I’m undergoing chemotherapy?

Some chemotherapy schedules are being modified [1]. For example, there may be a longer time between your chemotherapy sessions. This will help reduce the number of times you have to the hospital during this crisis.

What if I’m undergoing HER2-targeted therapy?

If you’re getting a HER2-targeted therapy (such as trastuzumab (Herceptin)) through an IV or a nurse-administered injection, your treatment may be modified [1]. For example, you may have a longer time interval between treatments. This will help reduce the number of times you have to the hospital during this crisis.

What if I’m on hormone therapy?

If you’re taking tamoxifen or an aromatase inhibitor for early breast cancer, your treatment will continue as usual.

If you have metastatic breast cancer and take hormone therapy along with a CDK4/6 inhibitor, mTOR inhibitor or PIK3CA inhibitor, your treatment may be modified [1]. This will help lower the risk of side effects that may require you to visit your doctor or medical center.

Should I be worried if imaging (MRI, PET scan or other imaging) related to my breast cancer is delayed?

If imaging related to a possible breast cancer diagnosis or related to your breast cancer is canceled and you have concerns, call your doctor.

Routine breast cancer screening is being postponed during this crisis (see below).

Can I still bring someone with me to my doctor’s appointment?

Many hospitals now limit the number people you can bring with you to reduce the spread of COVID-19. Call your hospital or check the website for their current policies. Don’t bring someone with you who has a fever or cough.

If you have a fever, cough or other symptoms, let your doctor know before you go to your appointment. 

Should I be worried if my routine screening mammogram is delayed?

Due to limits on resources and staff and to minimize exposure to COVID-19, your hospital or imaging center may postpone screening mammograms for some women. If you’re at average risk and have no signs of breast cancer and have had a mammogram in the past year or so, your mammogram may be postponed. Do not worry if this happens to you.

Study findings show for women 50-74, the benefits of mammography screening every year are similar to the benefits of mammography screening every 2 years [1]. In fact, the U.S. Preventive Services Task Force recommends mammography screening every 2 years for women ages 50-74 [1]. The American Cancer Society recommends mammography every 2 years for women, starting at 55 [2].

However, if you have any warning signs of breast cancer or notice any changes in your breast or underarm area, call your doctor.

Read Komen’s position on breast cancer screening during this crisis.

If you have questions about coronavirus (COVID-19) and breast cancer, visit the American Society of Clinical Oncology website.

What can I do to reduce stress?

This is a stressful time. To reduce stress, the CDC recommends:

  • Taking breaks from watching, reading, or listening to news stories about coronavirus, including social media.
  • Taking care of yourself. Try taking deep breaths, stretching or meditating. Try to eat healthy meals, get some exercise, get plenty of sleep, and avoid alcohol and drugs.
  • Making time to do things you enjoy, such as taking a walk, gardening, knitting, reading a book or cooking.
  • Talking with others about your concerns and how you’re feeling. Call, FaceTime or Skype with family and friends.

Susan G. Komen®’s Breast Care Helpline:
1-877 GO KOMEN (1-877-465-6636)

Our Breast Care Helpline can provide information, social support and help with coping strategies related to anxiety or concerns during these uncertain times. Calls to the helpline are answered by a trained and caring staff member in English or Spanish, Monday through Friday from 9:00 a.m. to 10:00 p.m. ET. You can also email the helpline at helpline@komen.org.

 

Where can I find social support during this crisis?

This is a hard time for everyone. Many breast cancer organizations are offering more social support services online and by telephone.

If you’re feeling scared or alone, or just need to talk, please reach out to Komen by calling our Breast Care Helpline at 1-877 GO KOMEN (1-877-465-6636). Our trained and caring helpline staff can provide information, social