Loss of paid employment after a diagnosis of breast cancer is common, often undesired, not restricted to the treatment period, and potentially related to the type of treatment administered. These findings should be considered when patients decide whether to receive adjuvant chemotherapy, particularly when the expected benefit is low.
Impact of adjuvant chemotherapy on long-term employment of survivors of early-stage breast cancer
Version of Record online: 28 APR 2014
© 2014 American Cancer Society
Volume 120, Issue 12, pages 1854–1862, 15 June 2014
How to Cite
Jagsi, R., Hawley, S. T., Abrahamse, P., Li, Y., Janz, N. K., Griggs, J. J., Bradley, C., Graff, J. J., Hamilton, A. and Katz, S. J. (2014), Impact of adjuvant chemotherapy on long-term employment of survivors of early-stage breast cancer. Cancer, 120: 1854–1862. doi: 10.1002/cncr.28607
Presented in preliminary form as an oral presentation at the 2011 American Society of Clinical Oncology Annual Meeting; June 3-7, 2011; Chicago, IL.
- Issue online: 3 JUN 2014
- Version of Record online: 28 APR 2014
- Manuscript Accepted: 9 DEC 2013
- Manuscript Revised: 11 NOV 2013
- Manuscript Received: 19 SEP 2013
- breast cancer;
- and End Results (SEER)
Many women with early-stage breast cancer are working at the time of diagnosis and survive without disease recurrence. The short-term impact of chemotherapy receipt on employment has been demonstrated, but the long-term impact merits further research.
The authors conducted a longitudinal multicenter cohort study of women diagnosed with nonmetastatic breast cancer between 2005 and 2007, as reported to the population-based Los Angeles and Detroit Surveillance, Epidemiology, and End Results program registries. Of 3133 individuals who were sent surveys, 2290 (73%) completed a baseline survey soon after diagnosis and of these, 1536 (67%) completed a 4-year follow-up questionnaire.
Of the 1026 patients aged < 65 years at the time of diagnosis whose breast cancer did not recur and who responded to both surveys, 746 (76%) worked for pay before diagnosis. Of these, 236 (30%) were no longer working at the time of the follow-up survey. Women who received chemotherapy as part of their initial treatment were less likely to be working at the time of the follow-up survey (38% vs 27%; P = .003). Chemotherapy receipt at the time of diagnosis (odds ratio, 1.4; P = .04) was found to be independently associated with unemployment during survivorship in a multivariable model. Many women who were not employed during the survivorship period wanted to work: 50% reported that it was important for them to work and 31% were actively seeking work.
Unemployment among survivors of breast cancer 4 years after diagnosis is often undesired and appears to be related to the receipt of chemotherapy during initial treatment. These findings should be considered when patients decide whether to receive adjuvant chemotherapy, particularly when the expected benefit is low. Cancer 2014;120:1854–1862. © 2014 American Cancer Society.