Table 3.

The effects of the pandemic the breast cancer (BC) journey: Patient perspectives.

Title	Findings	Study Design	Critical appraisal score (%)*
Lou et al., 202023	Participants receiving active treatment reported greater concern about infection from the SARS-CoV-2 coronavirus (p < 0.001), higher levels of family distress caused by the COVID-19 pandemic (p = 0.004), and greater concern that the general public does not adequately understand the seriousness of COVID-19 (p = 0.04). Those with metastatic disease were more likely to indicate that COVID-19 had negatively affected their cancer care compared to patients with non-metastatic cancer (50.8%vs.31.0%; p = 0.02). The most commonly reported treatment modifications included chemotherapy delays (N = 14, 53.8%), followed by delayed surgery (N = 5, 19.2%).	Cross sectional	80%
Miaskowski et al., 202024	Of 187 patients surveyed, 149 were diagnosed with BC. 31.6% of patients (compared to 29.6% of control) had high levels of COVID-19 related stress. While the Impact of Event Scale (IES-R) score to measure COVID-19 and cancer-related stress of 18.6 for the total sample was below the clinically meaningful cut-point, patients in the stressed group had a mean score of 36.9 (+10.1; range 24–60) which is alarmingly high and consistent with probable PTSD	Survey	80%
Papautsky et al., 202020	Forty-four percent of participants reported cancer care treatment delays during the pandemic. Delays in all aspects of cancer care and treatment were reported. The only variable which had a significant effect was age (97 (.95, 99), p < 0.001) with younger respondents (M = 45.94, SD = 10.31) reporting a higher incidence of delays than older respondents (M = 48.98, SD = 11.10). There was no significant effect for race, insurance, site of care, or cancer stage.	Survey	90%
Zhang et al., 202019	In addition to stress and concerns about COVID-19, patients were most concerned about BC diagnosis and treatment delays, especially delays of various BC surgeries. Patients did not report delays of diagnostic imaging or core-needle biopsy. This is consistent with the recommendations that urgent diagnostic imaging and biopsies should proceed as usual.	Qualitative	80%