Clinical Nurse Specialist Jane Murphy, who looks after Breast Cancer Now’s Helpline and Ask Our Nurses email service, answers some common questions about breast cancer and the coronavirus. Information is regularly reviewed and updated. Last reviewed 5 November 2020.
It’s important to follow guidance from the NHS on the coronavirus.
While we cannot comment on individual cases, here are some of the questions we are most commonly asked and what the guidance says, as we understand it. Please refer to your hospital teams or GP, where possible, with specific questions.
- I’m taking hormone therapy. Am I more at risk?
- Does having trastuzumab (Herceptin) mean I’m more at risk from coronavirus?
- I’ve had lymph nodes removed from my armpit. Does this affect my immunity?
- I'm going into hospital for an operation and worry about the risk of coronavirus
- I’ve been told my planned radiotherapy may be shortened. Is this safe?
- I’m currently having treatment. Am I more at risk from the coronavirus?
- What if I’m having treatment and live with someone who gets symptoms?
Hormone therapies, including tamoxifen, letrozole, anastrozole, exemestane and goserelin, do not affect your risk of getting coronavirus or of becoming seriously ill if you do get it.
Taking hormone therapy does not affect your immune system.
There have been various references in the media of a possible link between COVID-19 and hormones. In the UK this has recently become part of the data that is being collected by the COVID symptom study group. This group is trying to better understand how hormones, such as oestrogen, might affect the virus. However, the study is not looking at how reducing circulating oestrogen with hormone therapy might affect the virus.
Talk to your treatment team or call our Helpline if you are concerned about this.
Having trastuzumab (Herceptin) could mean you’re more at risk of getting coronavirus or becoming very ill if you get it.
The risk is likely to be higher if you’re having it with chemotherapy.
Targeted therapies like trastuzumab tend to have fewer serious side effects than chemotherapy. However, they can still cause problems in some people.
Read more about breast cancer treatment and coronavirus.
Having lymph nodes removed does not affect your body’s ability to fight infections such as the coronavirus.
It’s common to have lymph nodes under the arm removed as part of surgery for breast cancer.
While having lymph node surgery increases the risk of a condition called lymphoedema, having nodes removed or having lymphoedema does not affect the overall ability of the immune system to fight infection.
The NHS website has some up-to-date information on preparing for an operation. It says that you, the people you live with and anyone in your support bubble may need to self-isolate before you go into hospital.
You may find it useful to read guidance about planned surgery from NICE (the National Institute for Health and Care Excellence), published at the end of July. This says that for 14 days before surgery you will need to practise social distancing and follow hand hygiene routines. Three days before going into hospital you will need to have a coronavirus test. From the time of this test to your admission to hospital, you will need to isolate yourself completely.
Most hospitals will follow a procedure based on the NICE guidance.
It’s natural to feel worried. Our Helpline team are here if you need to talk.
Some people due to have radiotherapy may be told it will be given over a shorter period than originally planned.
For example, your treatment team may recommend five daily treatments over one week (Monday-Friday).
For several years, clinical trials have been looking at giving radiotherapy over shorter periods. One large trial has recently confirmed that people who received the shorter regime (five daily treatments of radiotherapy in a week compared to fifteen daily treatments over three weeks) have similar results. The trial found that giving radiotherapy over the shorter period was as safe and as effective as the longer period. The trial results so far are based on people who were followed up for five years in the two groups. The results following people up for 10 years are to be published shortly.
Based on these trials, radiotherapy experts believe shortening some people’s treatment is an acceptable way to be treated.
Having certain treatments for breast cancer could mean you’re more at risk of getting an infection such as the coronavirus, and more at risk of becoming seriously ill if you do get it.
This includes people having:
- immunotherapy or targeted (biological) therapies such as trastuzumab emtansine (Kadcyla) or everolimus (Afinitor)
- trastuzumab (Herceptin), or trastuzumab with pertuzumab (Perjeta), with or without chemotherapy (the risk is likely to be smaller if you’re not having chemotherapy as well)
- other targeted (biological) therapies which can affect the immune system, including palbociclib (Ibrance), ribociclib (Kisqali) and abemaciclib (Verzenios)
Compared with chemotherapy drugs, targeted therapies tend to have fewer serious side effects. However, they can still cause problems in some people.
Because of this, it’s best to contact your hospital team to check your individual risk.
People on these treatments usually have regular blood tests to check their white blood cell count. A low white blood count means you’re more at risk of infection.
People who have symptoms of the coronavirus are being told not to leave home. This is called self-isolation. Members of their household are also advised to stay home.
You can read the government's guidance on self-isolation. It says anyone with symptoms of coronavirus must immediately self-isolate and arrange to have a test to see if they have coronavirus. They should also avoid contact with other members of their household as much as possible.
Need to talk to someone? Our breast care nurses and highly trained staff on our free and confidential Helpline are here for you.