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Changes in treatment increased anxiety for breast cancer patients amid pandemic

Main Line Health researchers find that changes in treatment increased anxiety for breast cancer patients amid pandemic, and Main Line Health physicians respond to this patient need


The COVID-19 pandemic forced medical centers nationwide to delay or change course on treatment for many breast cancer patients. A new study by Main Line Health researchers has taken an in-depth look at the issue, finding the pandemic caused wide-ranging effects.


About 44% of patients saw changes to their breast cancer treatment plan due to the pandemic, according to the study led by the Center for Population Health Research at the Lankenau Institute for Medical Research (LIMR), part of Main Line Health. Regardless of whether their plan was altered, nearly 1 in 3 experienced elevated levels of anxiety and depression.


The study involved patients who needed medical evaluation or had a scheduled surgery date at Lankenau Medical Center or Bryn Mawr Hospital, two acute-care hospitals under Main Line Health, a community-based health system providing multidisciplinary breast cancer care throughout the Philadelphia region.


“This data is relevant to cancer care across the U.S. especially as we are now seeing an increase in COVID cases,” said lead author Kaitlyn Kennard, a postdoctoral fellow for

LIMR and Lankenau Medical Center surgical resident. “More than 75% of surgical care for breast cancer nationally is delivered in community hospitals. That means Main Line Health’s experience with the impact of COVID-19 reflects the majority of breast cancer care.”


Data was collected during the initial COVID-19 surge from March to June 2020. Surgery at the time was limited to essential cases. Established patients were seen via telemedicine. The study found 32 of the 73 enrolled patients (44%) had changes to their care. Changes included delay in therapy (15%) and use of hormonal therapy (29%) to compensate for delays in surgery. The median time to surgery for patients whose cases could not wait was 24 days.


Additionally, a survey showed nearly one-third of patients reported higher anxiety and depression. Those levels were similar regardless of whether the patient had a change in care or not. However, more than 55% of those with changes in care said they believed COVID-19 affected their treatment outlook.


“This study reinforces that we should have plans in place to meet the needs of patients with all types of cancer in the case of an emergent situation,” said Sharon Larson, executive director of the Center for Population Health Research and a study coauthor.


“Since the initial COVID-19 surge, we have been diligently working to address the pandemic’s impact on Main Line Health cancer patients,” said Michael Walker, MD, medical director, Main Line Health Cancer Care. “We have developed programs and services to help our patients through this challenging time.”


Walker cited creating online support groups and webinars, ensuring easy access to telemedicine, and providing early access to vaccines as examples of how the health system strived to serve patients and ease their anxiety.


“Main Line Health breast cancer nurse navigators have always been by a patient’s side throughout testing, diagnosis and treatment, and they came up with innovative ways to continue this support, which was needed more than ever,” Walker said.


The study, “COVID-19 Pandemic: Changes in Care for a Community Academic Breast Center and Patient Perception of Those Changes,” is in the September issue of Annals of Surgical Oncology.


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