How Did Breast Cancer Patients Fare during Different Phases of the COVID-19 Pandemic in Norway Compared to Age-Matched Controls?

Simple Summary: This study of Norwegian breast cancer cases and controls invited during different COVID-19 phases (social restrictions, high infection rate and post-COVID-19 phases) found consistently lower health-related quality of life (HRQoL) in women with breast cancer but minor differences across the three phases of the pandemic. Among breast cancer cases, young women who were living with children <18 years of age had the most HRQoL difficulties, whereas among controls, single women encountered the most difficulties. Living with children <18 had divergent effects on several HRQoL domains amongst cases and controls, with worse scores for breast cancer cases but better scores for controls. Hence, the burden of a cancer diagnosis (i.e., fatigue, worry, guilt, etc.) might be even greater among women with young children. Little is known about how health-related quality of life (HRQoL) in breast cancer cases differed from that of controls during and after the COVID-19 pandemic. This study used data from an ongoing, nationwide HRQoL survey of 4279 newly diagnosed breast cancer cases and 2911 controls to investigate how breast cancer patients fared during different phases of the pandemic compared to controls. Responders during 2020-2022 were categorized into three COVID-19-related phases: the social restrictions phase, the high infection rate phase, and the post-pandemic phase. Across phases, breast cancer cases had significantly worse scores in most HRQoL domains compared to controls. Apart from slightly more insomnia in the high infection rate phase for both cases and controls, and better social functioning for young cases in the post-COVID-19 phase, the case-control differences in HRQoL remained consistent across phases. When the phases were assessed as one period, young women and those living with children <18 years of age fared the worst among breast cancer cases, while single women fared the worst among controls. In contrast, controls living with children <18 years of age exhibited better HRQoL than controls without children. In summary, women with breast cancer did not appear to fare differently than controls in terms of HRQoL across COVID-19 phases. However, breast cancer cases with young children fared worse in their HRQoL than other breast cancer cases.