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'Mammograms Saved My Life': Why Breast Cancer Screenings During COVID-19 Matter

doctor in mask holding ipad looking at mammogram scans

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Key Takeaways

  • Breast cancer screenings and diagnoses declined sharply earlier this year, when the SARS-CoV-2 virus (COVID-19) hit the U.S.
  • It is now safe to go have mammograms and other screening or diagnostic tests and procedures for breast cancer.
  • Getting screened is as important for your health as taking precautions against COVID-19.
  • Everyone, whether diagnosed with breast cancer or not, should follow precautions to prevent exposure to the virus when in a doctor’s office or testing center.

The COVID-19 pandemic may have caused you to postpone mammograms or other breast cancer screenings, but it is time to reschedule, and it’s safe to do so, say experts.

When the world came to a grinding halt back in March, many testing centers temporarily shuttered, forcing people to cancel or postpone appointments, mammograms, and other screening tests. The decline in screening tests and diagnoses and the impact it has had in just a few months is staggering. In the United States, from January, 2019 through February, 2020, more than 2,200 women were diagnosed with breast cancer on a weekly basis. During the pandemic, that number dropped to 1,064 new diagnoses per week: a decrease of 51.8%. 

That may sound like good news, but it’s not. Fewer diagnoses were made because fewer women were getting screened. 

Without a diagnosis, treatment cannot take place, putting an average of more than 1,000 women per week at risk of delaying cancer treatment and possibly being diagnosed with a more advanced stage of cancer later. One estimate is that 33,890 cases of deaths due to breast cancer will occur because of the pause in screening and diagnoses.

“Back in the beginning of the pandemic, emergency departments were filling up with COVID-19 patients. If you weren’t sick with symptoms of the SARS-CoV-2 virus, you couldn’t get into the doctor’s office," Dorraya El-Ashry, PhD, Chief Scientific Officer of the Breast Cancer Research Foundation in New York City tells Verywell. "Annual screenings were told to wait, and most experts felt it was safe to hold off for a couple of months, but it turned into much longer."

Initially, patients couldn’t be seen because there was a shortage of masks for technologists and other healthcare workers.

“But eventually, many centers were able to come up with ways for patients to come in and get their breast cancer screening in socially distanced ways,” El-Ashry says. “For example, instead of sitting in a waiting room, people would wait in their car until they were called in, so there was not more than one patient in the office at a time. It has been increasingly possible to be able to go in and get mammograms.”

Mammograms, ultrasounds, and other procedures, such as biopsies or MRIs are important tools for breast cancer screening and diagnosis. Breast Cancer Month in October is a good time to start performing monthly breast self examinations and to schedule an appointment to have your breasts checked.

Screenings Are a Must for Your Bust

All women (and even some men) are at risk of developing breast cancer and should be screened. Although white women of European descent have a higher chance of being diagnosed with breast cancer, women of Latin, African, or Asian descent have a higher chance of being diagnosed with more aggressive breast cancer at a younger age.

“Black women have a much higher risk of dying from breast cancer, due to access factors and biological disparities,” El-Ashry says. And although the BRCA mutation that increases the risk of developing breast cancer is prevalent in Latinx women, breast cancer screening is known to be low among the population. The BCRF is addressing those problems through research, El-Ashry says.

If something unusual is detected on a mammogram, followup is needed to determine whether the spot is in fact a tumor, and if it is, whether it has spread outside of the breast through the many nearby lymph nodes. Getting a thorough evaluation leads to proper diagnosis and treatment. Without those, a good outcome is in jeopardy. That was almost the experience of Mandy Gonzalez, who was starring as Angelica Schuyler in the hit Broadway show “Hamilton” until COVID-19 shut down Broadway.

“I had my first mammogram in October, 2019, and a cyst was spotted,” Gonzalez tells Verywell. “They told me to come back in six months, and I almost didn’t go. I’m a working mom; self-care was not on my priority list. I had a 3D mammogram and then an ultrasound. Behind the cyst was a tumor.” Biopsy showed Gonzalez had invasive ductal carcinoma, stage 1.

Gonzalez had a lumpectomy in November, 2019, and started chemotherapy in January, 2020, going every Monday, when Broadway theaters are closed. “I was able to perform for two days after my treatment and then would start to feel fatigued on the third and fourth days,” Gonzalez says. “The old school mentality of ‘the show must go on’ was a healing force, and singing was my comfort. In the beginning of March, I was still going to chemotherapy in the city but started hearing rumblings about a pandemic. Then on March 11, Hamilton was put on pause.”

Gonzalez had to continue chemotherapy, even during the pandemic. “You can’t miss a treatment or an appointment, but eventually my treatment was moved near my home in New Jersey,” she says. Chemotherapy ended in April, and Gonzalez went through radiation in June. Her treatment is complete and a recent mammogram showed no signs of cancer. 

Gonzalez now strongly advocates for Latinx and Hispanic women to go for mammograms—and follow-up appointments—as a BCRF ambassador “Your health is number one. Breast cancer affects the whole family. Make and go to appointments not just for yourself but for your loved ones, too,” she says.

When To Get a Mammogram 

Organizations such as the American College of Obstetrics and Gynecology, the American Medical Association, and the American Cancer Society recommend starting mammograms at age 40, but no later than age 50, and having one every one to two years until about age 75.

Ultimately, the right time for you to start breast cancer screenings, the frequency that you have them, and when you don’t need them anymore is a matter of weighing your personal risk factors when you talk to your doctor. If you are in a high-risk group, such as having close relatives who have had breast cancer, your doctor may recommend that you start having mammograms at age 30. 

“Mammograms saved my life,” Lissa Poirot, a travel writer living in the Philadelphia area tells Verywell. “I had faithfully gone for mammograms every October for 10 years. Every year I was fine, and then one year I wasn’t. I had no pain, felt no lump. I had a 3D mammogram because I had dense breast tissue and it was caught that way. In just one year, the tumor formed and spread into one lymph node,” says Poirot. “I can’t stress it enough. The mammogram saved my life.”

Three weeks after her tumor was discovered, Poirot had a double mastectomy. She went through four rounds of chemotherapy and then reconstructive surgery. That was three years ago. She still sees her oncologist, but hasn’t had any trepidation about going to get checked during the pandemic. 

“Early on in the pandemic, my appointments were virtual telemedicine appointments. But as soon as I could go in person, I did,” she says. “Yes, I’m at high risk of getting the virus because of my cancer status, but I’m also at high risk of dying because of cancer. Going to a doctor’s office is one of the safest places you can go. I was the only patient in the office, and they took every precaution.”

“I worry about the people who don’t have cancer and don’t want to go get checked,” Poirot says. ”Many are nervous about it and think mammograms hurt. Cancer hurts a lot more.”

“If you feel something or sense something, trust your instincts and go get it checked, even if you’re younger than 40,” Gonzalez says. “To put it off is really detrimental.”

Lissa Poirot, Breast Cancer Survivor

I worry about the people who don’t have cancer and don’t want to go get checked. Many are nervous about it and think mammograms hurt. Cancer hurts a lot more.

— Lissa Poirot, Breast Cancer Survivor

What This Means For You

If you have breast cancer and are undergoing immunotherapy, such as for triple-negative breast cancer, your treatment may affect your lungs, possibly increasing your vulnerability to COVID-19. Take extra precautions when going to your medical appointments. Ask your provider if telemedicine visits are an option.

If you have breast cancer and are undergoing hormone therapy, your immune system is less compromised but you should still be cautious. “Breast cancer treatments tend to be less toxic to the immune system and don’t give patients an immunocompromised status,” El-Ashry says, “but they can affect the ability to fight off infections by bacteria and viruses so you may be administered white blood cells.”

If you completed treatments for breast cancer, continue your followup appointments. Take precautions such as wearing a mask and/or gloves.

If you have not been diagnosed with breast cancer but are due for a mammogram, go! "Today it is definitely riskier to hold off,” El-Ashry says. “The data from the decline in screenings and diagnoses during the pandemic tells us what happens if we hold off for a significant amount of time.”

Staying Safe During Mammograms and Other Medical Appointments

Ready to make an appointment with your doctor or schedule a mammogram? Here are a few tips to keep in mind when you go:

  • Try to get the first appointment of the day. Not only will you avoid the risk of the office running behind and making you wait longer than expected, you also will benefit from surfaces being clean and less exposed to other people.
  • Wear a mask—properly. Make sure your mask fits snugly and is covering your mouth and your nose.
  • Take your own pen. Pens at the sign-in desk and check-out counter may be cleaned and rotated throughout the day, but your safest bet is to bring your own pen to use when signing the log sheet or filling out paperwork.
  • Take your own reading material. Many offices have removed magazines from their waiting rooms to reduce the risk of spreading germs.
  • Wash your hands. Before you leave your home, wash your hands for at least 20 seconds, and make sure you wash your hands again when you get back home. If you must use the public restroom in the office, be sure to use a paper towel to flush the toilet, turn faucets on and off while washing your hands, and open the door on the way out.
  • Use hand sanitizer frequently. During your time in the office, use hand sanitizer frequently, such as when you sit down in the waiting room, after touching a door or counter, when you get into the exam room, and on your way out.
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Article Sources
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  2. Lai  A, Pasea  L, Banerjee  A,  et al. Estimating excess mortality in people with cancer and multimorbidity in the COVID-19 emergency.  medRxiv. Preprint posted online June 1, 2020. doi:10.13140/RG.2.2.34254.82242

  3. Breast Cancer Research Foundation. Where racial disparities persist in breast cancer care.

  4. Dense Breast-Info. Table: Screening guideline comparison in average-risk women. densebreast-Info.org. Updated April 2020.

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