OBJECTIVES: In March 2020, coronavirus (COVID-19) was declared a pandemic by the World Health Organization (WHO). Globally, 11 million cases and 500,00 deaths have been reported as of July 2020. Healthcare services were put under extreme pressure leading to re-deployment of medical staff and de-prioritization of non-emergency appointments, surgeries and diagnostic tests. This study focused on patients with breast cancer and aimed to understand their experiences during the pandemic.

METHODS: Publicly available posts from patients with breast cancer and/or caregivers (users) were programmatically extracted from the BreastCancer.org community COVID-19 sub-forum (March-June 2020). Posts were deidentified to protect patient privacy and subset to those containing mentions of words relating to breast cancer treatment. Qualitative review was conducted on a random sample of 170 posts from 91 users for inclusion in the thematic analysis.

RESULTS: Overall, 125 posts from 79 users contained discussions surrounding COVID-19. The most commonly mentioned themes were emotional/psychological impacts, disruptions to cancer treatment and sharing information/asking questions about COVID-19 (43%, 42% and 37% of users, respectively). The majority of emotional/psychological impacts related to cancer treatment (29% of users), including concerns and anxiety surrounding delayed appointments, attending appointments, and frustration from disruption to treatment. A quarter of users (25%) experienced cancelled treatments and surgeries, and 22% discussed postponed/delayed treatments and surgeries. Other themes uncovered included COVID-19 experiences and perceptions (e.g. lack of PPE and testing), and personal economic impacts (e.g. loss of jobs mid-treatment).

CONCLUSIONS: This was a novel study to uncover insights into COVID-19 impacts and concerns among patients with breast cancer. Our findings suggest there was significant disruption to routine care and a high level of associated emotional/psychological burden among patients. Future studies can build on this work to understand long-term impacts of COVID-19 and subsequent needs for patients with cancer as the pandemic evolves.