Coronavirus (COVID-19) and breast cancer

This page has information for people with breast cancer and their families.

For general information on coronavirus, visit the Centers for Disease Control and Prevention (CDC) website.

If you have another type of cancer, visit the American Society of Clinical Oncology website for information on coronavirus for people with cancer.

What is coronavirus?

The new coronavirus was first detected in China in late 2019. It causes the respiratory disease COVID-19, which stands for coronavirus disease 2019.

Most cases of COVID-19 are mild. However, some cases are severe and can lead to death.

For the latest information on the coronavirus, visit the CDC website.

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:

Cough
Shortness of breath
Fever
Chills
Muscle or body aches
Headache
Sore throat
Congestion or runny nose
New loss of taste or smell
Nausea or vomiting
Diarrhea

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, have been in contact with someone who’s been diagnosed with COVID-19 or have questions about testing for coronavirus, call your doctor.

For more information on the symptoms of COVID-19 and when to seek immediate medical attention for symptoms, 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 being in a public place 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.
Keep space between yourself and others outside of your home.
Avoid touching your eyes, nose and mouth.
Wear a cloth face cover when you go out in public (for example, to the grocery store). This is to protect other people in case you are infected. Do NOT put a face cover on young children or anyone who can’t remove it without help (for example, someone who has trouble breathing or is incapacitated in some way). Don’t use a face mask meant for a health care worker.
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.

For additional information about coronavirus (COVID-19) for people with cancer, visit the American Society of Clinical Oncology website.

Find more information on cloth face coverings on the CDC website.

Holiday plans and small gatherings

The holidays are usually a time to gather with family and friends. However, small gatherings, especially inside, are one reason the COVID-19 pandemic is getting worse.

This year, to lower the risk of coronavirus spread, the CDC recommends celebrating in-person only with those who live in your home, and getting together virtually (over the phone or computer) with family and friends who don’t live with you.

If you have a weakened immune system from breast cancer treatment (which puts you at an increased risk of getting sick from COVID-19), the CDC recommends avoiding in-person gatherings with people who don’t live in your home.

Rates of COVID-19 are not the same in everywhere, so local and state government safety guidelines vary and can change often. Check your local and state government websites for the latest information on size restrictions for gatherings and other safety guidelines.

Find more information from the CDC on holiday plans and small gatherings.

Whether or not your surgery is postponed depends on your hospital and surgeon, as well as your state and local guidelines.

Don’t worry if your surgery is postponed. If this happens, your breast cancer treatment may begin with chemotherapy or hormone therapy.

Increased use of neoadjuvant (before surgery) therapy

Many people get chemotherapy or hormone therapy before breast surgery. This is called neoadjuvant therapy. If you need chemotherapy, 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.

If your breast cancer surgery is postponed due to the pandemic, you may get neoadjuvant therapy. If you will need chemotherapy after surgery, your doctor may start you on neoadjuvant chemotherapy first and do surgery later [1]. Neoadjuvant chemotherapy is not given to people who don’t need chemotherapy.

Some women with very small estrogen receptor-positive breast cancers who don’t need chemotherapy may get neoadjuvant hormone therapy for 6-12 months [1]. After surgery, hormone therapy will be continued.

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

When is surgery unlikely to be postponed?

Whether or not your surgery is postponed depends on your hospital and surgeon, as well as your state and local guidelines.

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

Will my breast reconstruction be postponed?

Some breast reconstruction surgeries may be 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].

You can still get breast cancer treatment during stay at home and shelter in place orders. Getting medical care is an essential service.

Some in-person doctor appointments may be changed to phone or video consults. We’ve created a simple checklist with some great tips to help you prepare for a successful visit.

Some doctors’ offices have made changes to allow for social distancing. For example, they have spread out appointments so only a few people are in the waiting area at the same time.

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

If you’ve already started radiation therapy, your treatment should continue [1]. However, your treatment plan may be modified to decrease the number of times you have to go to the hospital during this pandemic [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]. These women may skip radiation therapy [1].

Some chemotherapy schedules may be 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 go to the hospital.

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 go to the hospital.

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

Many clinical trials for breast cancer treatment are ongoing. If you’re in a clinical trial, there may be some changes to reduce your risk of exposure to COVID-19. For example, you may have fewer in-person doctor visits.

Hospitals may have limited staff and resources during this pandemic. So, individual hospitals made decisions about the clinical trials they conduct. Some hospitals temporarily put enrollment of new participants in clinical trials on hold.

If you have metastatic breast cancer and have exhausted treatment options, including clinical trials, you may be able to try an investigational drug through the FDA’s Expanded Access program. This is also known as compassionate use. Learn more about this program.

If imaging (MRI, PET scan or other imaging) related to a possible breast cancer diagnosis or related to your breast cancer is postponed and you have concerns, call your doctor.

Routine breast cancer screening may be postponed during this pandemic (see below).

Many places are limiting the number people you can bring with you to a doctor’s appointment. This is to help reduce the spread of COVID-19. Call your doctor or 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.

Many people are out of work or facing other financial hardship during this pandemic.

Komen Treatment Assistance Program

Susan G. Komen^®offers the Komen Treatment Assistance Program to eligible, underserved individuals who are actively undergoing breast cancer treatment.

With this program, we aim to help those who are facing financial challenges by providing: limited financial assistance, breast cancer education, psychosocial support and information about local resources.

Funding helps women and men of any age who have been diagnosed with breast cancer, at any stage of the disease. Financial assistance is granted to those who meet pre-determined eligibility criteria. To learn more about this program and other helpful resources, call the Komen Breast Care Helpline at 1-877 GO KOMEN (1-877-465-6636).

Other organizations may offer financial assistance during the COVID-19 pandemic.

For example, CancerCare has financial assistance for people undergoing cancer treatment who are affected by COVID-19. Call 800-813-4673 or visit www.cancercare.org/coronavirus to learn more.

Find information on how to maintain health insurance coverage after a job loss.

Find more financial assistance resources.

Due to limits on resources and staff and to minimize exposure to COVID-19, many hospitals and imaging centers postponed screening mammograms for some women. Now, many places have begun offering screening mammograms again. If you’re due for a screening, call to make an appointment.

Hospitals and imaging centers are taking many precautions to ensure patients are safe. Many places have made changes to allow for social distancing. For example, they have spread out appointments so only a few people are in the waiting area at the same time.

If your mammogram is postponed

If you’re at average risk and have no signs of breast cancer and have had a mammogram in the past year or so, don’t worry if your mammogram is postponed for a short period of time. You should be able to reschedule your mammogram soon.

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 of breast cancer or notice any changes in your breast or underarm area, call your doctor.

Read Komen’s position on breast cancer screening as communities begin to re-open.

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

If you have any warning signs of breast cancer or notice any changes in your breast or underarm area, don’t put off seeing your doctor. A breast lump or other change needs to be checked.

It’s OK to go see your doctor, even during the COVID-19 pandemic. Hospitals and doctor offices are taking many precautions to ensure patients are safe.

Hospitals are not postponing follow-up tests for people with signs or symptoms of breast cancer. These tests are considered urgent.

Learn more about warning signs of breast cancer.

Learn more about what to do if you find a lump.

Learn about follow-up tests and diagnosis.

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 pandemic?

This is a hard time for everyone. Many breast cancer organizations are offering 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 support and help with coping strategies related to anxiety or concerns during these uncertain times.

SUSAN G. KOMEN^® SUPPORT RESOURCES

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. Call 1-877 GO KOMEN (1-877-465-6636) or email the helpline at helpline@komen.org.
We offer an online support community through our closed Facebook Group – Komen Breast Cancer group. The Facebook group provides a place where those with a connection to breast cancer can discuss each other’s experiences and build strong relationships to provide support to each other. Visit Facebook and search for “Komen Breast Cancer group” to request to join the closed group.

Find more support resources.

References

Dietz JR, Moran MS, Isakoff SJ, et al. Recommendations for prioritization, treatment, and triage of breast cancer patients during the COVID-19 pandemic. the COVID-19 pandemic breast cancer consortium. Breast Cancer Res Treat. 181(3):487-497, 2020.
Correa C, McGale P, Taylor C, Wang Y, et al. for the Early Breast Cancer Trialists’ Collaborative Group (EBCTCG). Overview of the randomized trials of radiotherapy in ductal carcinoma in situ of the breast. J Natl Cancer Inst Monogr. 2010(41):162-77, 2010.
Goodwin A, Parker S, Ghersi D, Wilcken N. Post-operative radiotherapy for ductal carcinoma in situ of the breast. Cochrane Database Syst Rev. 11:CD000563, 2013.
National Comprehensive Cancer Network (NCCN). NCCN Clinical practice guidelines in oncology: Breast cancer V.4.2020. http://www.nccn.org/, 2020.
Siu AL on behalf of the U.S. Preventive Services Task Force. Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 164(4):279-96, 2016.
American Cancer Society. American Cancer Society recommendations for the early detection of breast cancer. https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html, 2020.

Posted August 11, 2020