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COVID-19 and Breast Cancer Care: Are Younger Patients at Higher Risk of Treatment Delays?

By: Hope Craig, MSPH
Posted: Friday, October 9, 2020

Younger patients with breast cancer appear to experience a disproportionate burden of treatment delays related to the COVID-19 pandemic. In April 2020, Elizabeth Lerner Papautsky, PhD, and Tamara Hamlish, PhD, of the University of Illinois at Chicago, conducted an online survey of more than 600 patients with breast cancer. Published in Breast Cancer Research and Treatment, the results showed that nearly half of respondents (44%) experienced delays in care during the early weeks of the COVID-19 pandemic, and younger respondents were more likely to experience these delays.

“Overall, we see there is a serious gap in disaster preparedness when it comes to providing critical and often time-sensitive care for breast cancer patients,” commented Dr. Hamlish in a University of Illinois press release.

The highest rates of delays were in routine follow-up visits (79%), breast cancer reconstruction surgery (66%), diagnostic imaging (60 %), and lab testing (50%). Contrary to the usual trends in health care, the investigators noted, the sole demographic characteristic with a significant effect on the likelihood of delay was age (P < .0001): Younger respondents (M = 46) reported a higher incidence of delays than older respondents (M = 49). These trends may be attributed, in part, to the types of breast cancer and cancer care specific to young women, particularly ovarian suppression.

Of note, younger patients tended to experience more aggressive disease and higher rates of breast cancer mortality, whereas older patients had a higher risk of mortality from COVID-19, with an increased risk due to exposure during hospital or clinic-based treatment. As strategies emerge to address treatment delays, the authors emphasized that it is essential to account for differential impacts of delays across the health-care system, including documented age disparities in breast cancer and COVID-19 mortality.

Disclosure: The authors reported no conflicts of interest.



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