Patients with breast cancer who underwent more aggressive treatment were likely to experience greater disruptions to employment and work, a study published in Cancer has shown.
Patients with breast cancer are faced with broad-ranging therapeutic options that include chemotherapy and surgical management, such as bilateral mastectomies, breast-conserving surgery, and reconstruction, but the impact these various interventions have on employment have not been thoroughly evaluated.
For this study, researchers sent surveys to 3672 patients with breast cancer and received 2502 responses. The responses of the 1006 women who reported working prior to their diagnosis were analyzed.
Responses showed that 62% of patients underwent lumpectomy, 16% underwent unilateral mastectomy (8% with reconstruction), and 23% underwent bilateral mastectomy (19% with reconstruction). Approximately 33% of patients received chemotherapy.
Eight-four percent of responders worked full-time before their diagnosis, and only 38% reported having flexible work schedules, 39% reported having disability benefits, and 50% reported having paid sick leave.
Patients who underwent surgical procedures (bilateral mastectomy with reconstruction vs lumpectomy) were strongly correlated with missing more than 1 month of work (odds ratio [OR] 7.8) and with stopping work completely (OR 3.1).
A higher correlation was also found for patients who received chemotherapy (OR for missing more than 1 month, 1.3; OR for stopping work completely, 3.9), patient race (blacks vs whites: OR for missing more than 1 month, 2.0; OR for stopping work completely, 1.7).
Patients who had paid sick leave or flexible work schedules were less likely to stop working.
The authors concluded “[i]n addition to policies that further improve employment support, practical actions by clinicians to reduce the overuse of aggressive treatments are of critical importance.”
Jagsi R, Abrahamse PH, Lee KL, et al. Treatment decisions and employment of breast cancer patients: results of a population-based survey [published online October 9, 2017]. Cancer. doi: 10.1002/cncr.30959