Breast Cancer and COVID-19: The Effect of Fear on Patients' Decision-making Process

In Vivo. 2020 Jun;34(3 Suppl):1651-1659. doi: 10.21873/invivo.11957.


Background/aim: Coronavirus-19 (COVID-19) pandemic outbreak is currently having a huge impact on medical resource allocation. Breast Cancer (BC) patients are concerned both with BC treatment and COVID-19. This study aimed to estimate the impact of anxiety among patients, caused by the spreading of COVID-19.

Patients and methods: Between the 16th of January and the 20th of March 2020, we retrospectively enrolled 160 patients. Eighty-two patients with a suspected breast lesion (SBL) were divided into two groups: PRE-COVID-19-SBL and POST-COVID-19-SBL. Seventy-eight BC patients were divided into PRE-COVID-19-BC and POST-COVID-19-BC. Patient characteristics including age, marital status, SBL/BC diameter, personal and family history of BC, clinical stage and molecular subtype were recorded. Procedure Refusal (PR) and Surgical Refusal (SR) were also recorded with their reason.

Results: BC and SBL analysis showed no difference in pre-treatment characteristics (p>0.05). Both POST-COVID-19-SBL and POST-COVID-19-BC groups showed higher rates of PR and SR (p=0.0208, p=0.0065 respectively). Infection risk represented primary reason for refusal among POST-COVID-19 patients.

Conclusion: COVID-19-related anxiety could affect patients' decision-making process.

Keywords: COVID-19; SARS-SOV-2; anxiety; breast cancer; decision-making process; surgery; surgery refusal.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anxiety / etiology
  • Anxiety / psychology*
  • Attitude to Health
  • Biopsy, Large-Core Needle / methods
  • Biopsy, Large-Core Needle / psychology*
  • Breast Neoplasms / diagnostic imaging
  • Breast Neoplasms / pathology
  • Breast Neoplasms / psychology*
  • Breast Neoplasms / surgery
  • COVID-19
  • Coronavirus Infections / psychology*
  • Decision Making*
  • Elective Surgical Procedures / psychology*
  • Fear / psychology*
  • Female
  • Humans
  • Italy
  • Mammography
  • Mastectomy / psychology*
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / psychology*
  • Retrospective Studies
  • Socioeconomic Factors
  • Treatment Refusal / psychology*
  • Ultrasonography, Mammary
  • Vacuum