The COVID-19 pandemic has had a significant impact on Australians affected by breast cancer. We have seen a decline in breast cancer cases as well as changes to the provision of optimal care.

After the initial outbreak of coronavirus in Australia in March, we surveyed our members to better understand the impact on, and experiences of, people affected by breast cancer. More than 2,300 people participated.

The survey found that the COVID-19 pandemic affected all aspects of breast cancer care, including diagnosis, treatment, follow-up care and supportive care.

As we evaluate these experiences and explore the impact of COVID-19 on people affected by breast cancer, BCNA will be focusing its efforts on addressing these challenges in 2021 and beyond.

You can read about the survey findings in the latest edition of The Beacon magazine: ‘Your voices help us ensure COVID-19 lessons are learned’.

Key priority areas

Key priority areas include:

• late and delayed diagnosis of breast cancer
• delays to breast reconstruction surgery
• the experience of using telehealth
• the impact of hospital visitor restrictions on people affected by cancer and their families
• challenges to accessing palliative care.

Late and delayed diagnosis of breast cancer

We are concerned about the decline in breast cancer reporting, particularly in Victoria, which has occurred from April to September 2020.

The most recent data from the Victorian Cancer Registry shows a sustained reduction in pathology notifications, with little or no sign of a return to usual levels. This data continues to inform the work of BCNA with the Victorian Cancer COVID-19 Network as the focus shifts to surge planning. Initially decreases in imaging procedures were seen at a national level, though have rebounded.[1]

Breast reconstruction

We are concerned about the impact of delays on elective surgery particularly in relation to breast reconstruction surgery. We have heard from breast cancer surgeons that bans on elective surgery through COVID-19 have meant that many women have not been able to have immediate reconstruction as part of their breast cancer surgery. These bans have resulted in a backlog of surgeries, with some health services outlining already long waiting lists for breast reconstruction surgery.

We will be monitoring waiting times around the country, and would welcome information you may have about wait times in your area.

Telehealth

Another focus for BCNA will be advocating for an improvement to telehealth services. While our survey found many people had very positive experiences with the rapid roll out of telehealth services, there were some clear areas where improvement is needed. These improvements include accessibility, equity and the development of best practice guidelines for the use of telehealth in cancer care.

BCNA and BCNA Consumer Rep Leslie Gilham are currently supporting research being conducted by the Victorian COVID-19 Cancer Network which aims to evaluate the experience of patients who have experienced telehealth via both video and phone consultations.

Hospital visitation

Hospital visitation restrictions continue to be a challenge nationally for those diagnosed with breast cancer. Health services continue to impose local restrictions on visitors; BCNA is calling for consistency to alleviate distress for patients and health care professionals.

BCNA is also working with government to understand the roadmap which would allow cancer patients to have support people with them when undergoing treatment or meeting with their treating team.

Palliative care

Through COVID-19 there have been restrictions for those at end of life care. Visitation restrictions, access to timely care in health services and lack of access to community services have caused much distress.

BCNA contributed to the Victorian COVID-19 Government Inquiry into palliative care and continues to work with governments to ensure that those with metastatic breast cancer do not die alone and that health services follow the Department of Health and Human Services Guidelines regarding visitation support for those seeking palliative care services.

Other priorities

BCNA will continue to be involved in discussions with key cancer agencies about the future provision of cancer care in Australia beyond the COVID-19 crisis. Projects include Cancer Australia’s COVID-19 Recovery: Implications for cancer care project and CHF’s Consumers Health Forum of Australia’s Consumer Commission: Beyond COVID-19.

If there is anything you would like to share with us about the ongoing impacts of the COVID-19 pandemic on Australians affected by breast cancer, or cancer care into the future, please email us at helpline@bcna.org.au.

[1] Cancer Australia, 2020. Review of the impact of COVID-19 on medical services and procedures in Australia utilising MBS data: Skin, breast and colorectal cancers, and telehealth services, Cancer Australia, Surry Hills, NSW.

For more information visit: COVID-19 vaccine: Information for people affected by breast cancer