Issues Over Breast Cancer Treatment in Pandemic are Easing

The global pandemic hindered the care of patients diagnosed with breast cancer, as it did many aspects of life.

Breast cancer treatment is an essential aspect of health care, with complex roots involving patient care, quality treatments, research, technology, innovation and more. Even COVID-19 couldn’t stop experts from facing breast cancer head-on, including the continuation of quality care.

According to the Centers for Disease Control and Prevention, about 264,000 breast cancer cases are diagnosed in women annually. Breast cancer deaths include 42,000 women and 500 men in the U.S. each year. Treatment of the disease consists of surgery, chemotherapy, hormonal therapy, biological therapy, radiation therapy or a combination of those. Doctors of varying specialties work together in the treatment, including surgeons and oncologists.

The Mayo Clinic’s Dr. Matthew P. Goetz is a professor of oncology and pharmacology, Erivan K. Haub professor of cancer research, enterprise deputy director of translational research, and director of Mayo Breast Cancer SPORE. He said that the significant impact that COVID-19 had on most oncology practices “was related to surgical access.”

Dr. Amy C. Degnim, Joe M. and Ruth Roberts professor of surgery at the Mayo Clinic College of Medicine, agreed.

“In the first few months of the pandemic, surgical access was greatly reduced,” she said.

In addition, safety was a concern across the board.

“The primary issue was that in the very early days of the pandemic, it was not clear how we could operate on patients and deliver general anesthesia in a way that would have a low risk of infection and good safety protocol for health care workers,” Degnim said.

With an abundance of caution, innovation and adapting to what was becoming “normal,” Degnim said they ironed out protocols for preoperative patient testing, and experts teased out the most optimal health care worker precautions.

“During that time, patients were assessed regarding level of urgency,” she said. “Those who needed surgery most urgently were operated on using the precautions that we had. Patients who were less urgent were deferred.

As a result, many wait-listed patients received active medical therapies for breast cancer treatment while waiting for surgery.

Those issues have eased substantially, said Goetz. After the initial effect, health care workers and surgical teams put themselves in overdrive, working “overtime to catch up and complete surgeries for all the patients who were delayed,” according to Degnim.

Currently, the pandemic has minimal impact on breast cancer care, including surgical scheduling. While preoperative COVID-19 testing is still in practice, Degnim said, “in the unlikely event that a patient does test positive for COVID, then their surgery is delayed until they are no longer infectious.”