Women are skipping breast exams, fighting cancer complicated by COVID-19

Breast cancer diagnosis down 50 percent, sparking concerns that cancer won’t be detected soon enough

Kari Rawley was already battling breast cancer when she was diagnosed with COVID-19. Like many breast cancer patients, Rawley had to cease treatment that suppressed her immune system. (Noah Taborda/Kansas Reflector)

Amid a battle with breast cancer, Kari Rawley found herself combating a second potentially fatal condition — COVID-19.

The Kansas City resident thought she had done everything right to help herself in her immunocompromised state. Her family wore masks and practiced social distancing, but after a small going away party for her daughter with family and close friends, Rawley tested positive, and later so did several other family members.

Rawley’s coronavirus symptoms began as they often do with aches and pains before transitioning to severe fatigue, breathing problems and eventually pneumonia. Rawley was admitted to the hospital for treatment.

“The worst part was being in the hospital alone and not knowing,” Rawley said. “At home, I had three other family members that also had COVID, and a sister and her husband ended up being positive also. So, the fear of the unknown and not knowing if it would get better or the next day I was going to end up on a ventilator.”

COVID-19 risks are amplified for immunosuppressed breast cancer patients, and women nationwide are opting out of coming in for mammograms for fear of contracting the virus. This leaves women at risk of developing advanced breast cancer.

Those already diagnosed, like Rawley, often must cease treatment that suppresses their immune system. Rawley, for example, was asked to hold her medication from her COVID-19 diagnosis until she was clinically improving.

“COVID-19 infection this year has been a big hurdle in the cancer world to deal with because, as we know, cancer doesn’t stop for COVID,” said Lauren Nye, Rawley’s medical oncologist at the University of Kansas Health System. “We’ve had to figure out ways to continue on treatments and to continue our screening and still take care of our patients.”

Nye said altering treatment is often necessary so as not to put patients at further risk, but this can complicate their outcome. While telehealth is an option, she said coming into the clinic for cancer treatment is still one of the safest courses of action.

A concerning trend amid COVID-19, however, is curbing the number of patients receiving treatment. Since the pandemic began, there has been a 50% drop in the number of breast cancer diagnoses across the country.

Jamie Wagner, chief of the Breast Surgery Division at KU Health System, said this is not because there is less breast cancer, but rather because of a fear of contracting COVID-19 driving people to put off breast cancer screening.

“What that then leads to is women finding it at more advanced stages, and that’s when they’re finally coming in versus what that screening mammogram would have otherwise picked up at an early stage,” Wagner said. “That dramatically changes the breast cancer treatment that we then can offer patients, and a lot of times it’s much, much more significant types of treatments they are having to receive.”

Wagner said the number of diagnoses did rise in October, Breast Cancer Awareness Month, but not enough to offset the decrease amid the pandemic. She said women should still come in for a yearly screening and that they should not be worried about contracting coronavirus.

Patients are spaced out in waiting rooms, equipment is sterilized, and all technicians and physicians are using appropriate personal protective equipment. Online scheduling also allows increased flexibility and reduced chance of virus transmission.

“We’ve really settled on very good procedures. We have very good PPE stores now. There are masks available, and there is eye protection,” said Dana Hawkinson, medical director of infection prevention and control at KU Health System. “It’s all geared toward keeping the patients safe from each other, keeping the patient safe from the health care workers and keeping the health care workers safe from each other as well.”