{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T15:34:41Z","timestamp":1790868881238,"version":"4.1.0"},"reference-count":49,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2023,12,21]],"date-time":"2023-12-21T00:00:00Z","timestamp":1703116800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Pfizer Inc."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>This study reported the prevalence of financial distress (financial toxicity (FT)) and COVID-19-related economic stress in patients with breast cancer (BC). Patients with BC were recruited from the Ciitizen platform, Breastcancer.org, and patient advocacy groups between 30 March and 6 July 2021. FT was assessed with the COmprehensive Score for financial Toxicity (COST) instrument. COVID-19-related economic stress was assessed with the COVID-19 Stress Scale. Among the 669 patients, the mean age was 51.6 years; 9.4% reported a COVID-19 diagnosis. The prevalence rates of mild and moderate\/severe FT were 36.8% and 22.4%, respectively. FT was more prevalent in patients with metastatic versus early BC (p &lt; 0.001). The factors associated with FT included income \u2264 USD 49,999 (adjusted odds ratio (adj OR) 6.271, p &lt; 0.0001) and USD 50,000\u2013USD 149,999 (adj OR 2.722, p &lt; 0.0001); aged &lt;50 years (adj OR 3.061, p = 0.0012) and 50\u201364 years (adj OR 3.444, p = 0.0002); living alone (adj OR 1.603, p = 0.0476); and greater depression severity (adj OR 1.155, p &lt; 0.0001). Black patients (adj OR 2.165, p = 0.0133), patients with income \u2264 USD 49,999 (adj OR 1.921, p = 0.0432), or greater depression severity (adj OR 1.090, p &lt; 0.0001) were more likely to experience COVID-19-related economic stress. FT was common in patients with BC, particularly metastatic disease, during COVID-19. Multiple factors, especially lower income and greater depression severity were associated with financial difficulties during COVID-19.<\/jats:p>","DOI":"10.3390\/cancers16010062","type":"journal-article","created":{"date-parts":[[2023,12,22]],"date-time":"2023-12-22T01:19:42Z","timestamp":1703207982000},"page":"62","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Financial Toxicity among Patients with Breast Cancer during the COVID-19 Pandemic in the United States"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-3348-9232","authenticated-orcid":false,"given":"Yan","family":"Wu","sequence":"first","affiliation":[{"name":"Ernest Mario School of Pharmacy, Rutgers University, Piscataway, NJ 07103, USA"},{"name":"Pfizer Inc., New York, NY 10001, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianchen","family":"Liu","sequence":"additional","affiliation":[{"name":"Pfizer Inc., New York, NY 10001, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martine C.","family":"Maculaitis","sequence":"additional","affiliation":[{"name":"Oracle Life Sciences, Austin, TX 78741, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Li","sequence":"additional","affiliation":[{"name":"Pfizer Inc., New York, NY 10001, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Berk","sequence":"additional","affiliation":[{"name":"Invitae Corporation, San Francisco, CA 94103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelina","family":"Massa","sequence":"additional","affiliation":[{"name":"Invitae Corporation, San Francisco, CA 94103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marisa C.","family":"Weiss","sequence":"additional","affiliation":[{"name":"Breastcancer.org, Ardmore, PA 19003, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynn","family":"McRoy","sequence":"additional","affiliation":[{"name":"Pfizer Inc., New York, NY 10001, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,12,21]]},"reference":[{"key":"ref_1","unstructured":"(2022, June 01). 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