As the world around us continues to evolve under the shadow of the COVID-19 pandemic, UPMC Western Maryland’s physicians who work to diagnose and treat breast cancer have a clear message – delaying preventative care is a risk that should not be taken.

According to recent research by the EPIC Health Research Network, that included 2.7 million patients across 190 hospitals nationwide, appointments for breast cancer screenings were down between 86% and 94% during the month of March compared to the average volumes in the previous three years. “We don’t know what impact – both immediate and long term – this is going to have, but there is a concern that patients will have more symptoms and a more advanced stage of cancer that could need a more aggressive treatment,” said Dr. Blanche Mavromatis, Medical Director, Breast Program and Oncology Clinical Trials, medical oncologist.

UPMC Western Maryland primary care physician Mary Ann Riley put it in the simplest of terms. “Screening saves lives. The earlier we detect and treat breast cancer the better results we can achieve.” Dr. Michael Dwyer, UPMC Western Maryland radiologist agreed, adding, “Any time you have a potential diagnosis of cancer, the earlier the diagnosis is made, and the treatment and therapy begins, the better.” “It’s important to continue these essential screenings,” said Dr. Beth Jelinek, UPMC Western Maryland obstetrician-gynecologist. “Delays in diagnoses can have devastating effects for patient care, so if you have concerns if screenings are necessary during the pandemic, be open and honest with your provider so the risks and benefits can be addressed.”

Even during the peak of the pandemic’s uncertainty earlier this spring, care continued to be provided at UPMC Western Maryland. “Despite the drop off in screenings, we were very fortunate that we were able to stay open and treat patients during the early part of the pandemic,” Dr. Mavromatis said. “We have been able to continue our care, and UPMC Hillman Cancer Center provided guidelines to follow when delivering treatments like chemotherapy, when necessary, with the intent that it would not l

ower the patient’s immune system and put them at a greater risk for COVID-19.”

“We continued to see all breast cancer patients without delay,” said Dr. Emme Jackson, UPMC Western Maryland plastic and reconstructive surgeon. “We staggered their appointments to ensure they were the only ones here at the time of their visit.” Other safety measures like masking were in effect long before they were mandatory. “Some of these patients are on chemotherapy and we needed to protect them from this virus,” she said.

“Early in the pandemic many patients cancelled and delayed routine yearly appointments,” Dr. Riley said. “I certainly understand why patients would choose to delay care during such uncertain times; however, in order to prevent further delay of care UPMC Western Maryland has made many changes to the way we offer appointments and testing to our patients to ensure the safest possible experience.”

In response to the pandemic, strict safety measures have been put in place across all facets of UPMC Western Maryland’s facilities, from temperature screenings to social distancing measures, as well as restrictions on patient visitation and waiting room changes. These measures ensure that necessary procedures, like mammograms, can proceed on schedule.

That does not mean that care has come without its challenges for the physicians. “Especially earlier in the pandemic, a lot of patients were coming in with a higher level of stress due to the unprecedented situation,” said Dr. Mavromatis. “In addition, many people in their support system were isolated from them due to quarantining, and that led to an additional struggle. They needed even more support from their providers than usual. Additionally, our safety precautions have made it more difficult in some regards, for example, wearing masks has made it more difficult to communicate with the patient. Not being able to show facial expressions makes it harder to express empathy.”

Despite these challenges and adaptations, screenings are slowly returning to pre-pandemic levels. If patients still prefer not to come to the hospital, there are other options, such as virtual visits with their doctors. “With one simple text we can be face to face with our patient within seconds. Either type of appointment (in person or virtual) allows us to evaluate our patients and order necessary testing, especially mammograms,” Dr. Riley said.

“We encourage patients to talk to their primary care provider to determine what level of risk they have,” Dr. Mavromatis said. “There are certain risk factors that are red flags and different levels of risk require different screenings. If your mammogram had to be rescheduled or you have fallen behind, you need to come in if you feel comfortable doing so. If not, you need to at least maintain regular visits with your provider and use a virtual visit. Of course, if you develop any symptoms or notice any differences in your breasts, you need to get evaluated immediately.”

Collectively the message across the many departments that work with breast cancer is the same. “Go to your yearly check-up if possible. Do not wait six months after your due time to get your mammogram,” Dr. Jackson said. “My recommendation has not changed,” Dr. Riley said. “Breast cancer screening is essential. While the process has changed slightly, the need to be screened has not changed. We have developed processes to keep our patients safe. One in eight women will develop breast cancer, so if you stop and think about your immediate family, that likely means breast cancer will affect someone you know and love dearly. Get your mammogram.”