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Impact of Adjuvant Chemotherapy on Long-Term Employment of Early-Stage Breast Cancer Survivors
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Details:
  • Pubmed ID:
    24777606
  • Pubmed Central ID:
    PMC4047155
  • Funding:
    1U58DP00807-01/DP/NCCDPHP CDC HHS/United States
    K05 CA111340/CA/NCI NIH HHS/United States
    K05CA111340/CA/NCI NIH HHS/United States
    N01-PC-35139/PC/NCI NIH HHS/United States
    N01-PC-35145/PC/NCI NIH HHS/United States
    N01-PC-54404/PC/NCI NIH HHS/United States
    N01PC35139/CA/NCI NIH HHS/United States
    N01PC35145/CA/NCI NIH HHS/United States
    N01PC54404/CA/NCI NIH HHS/United States
    R01 CA088370/CA/NCI NIH HHS/United States
    R01 CA088370/CA/NCI NIH HHS/United States
    R01 CA109696/CA/NCI NIH HHS/United States
    R01 CA109696/CA/NCI NIH HHS/United States
  • Document Type:
  • Collection(s):
  • Description:
    Background

    Many women with early-stage breast cancer are working at the time of diagnosis and survive without recurrence. The short-term impact of chemotherapy receipt on employment has been demonstrated, but the long-term impact merits further research.

    Methods

    We conducted a longitudinal multicenter cohort study of women diagnosed with non-metastatic breast cancer in 2005–2007, as reported to the population-based Los Angeles and Detroit SEER registries. Of 3133 individuals sent surveys, 2290 (73%) completed a baseline survey soon after diagnosis and 1536 (68%) completed a four-year follow-up questionnaire.

    Results

    Of the 1026 patients aged <65 at 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 follow-up. Women who received chemotherapy as part of initial treatment were less likely to work at follow-up (38% vs. 27%, p=0.003). Chemotherapy receipt at the time of diagnosis (OR 1.4, p=0.04) was independently associated with unemployment during survivorship in a multivariable model. Many women who were not employed in the survivorship period wanted to work: 50% reported that it was important for them to work and 31% were actively seeking work.

    Conclusions

    Unemployment among breast cancer survivors four years after diagnosis is often undesired and appears related to the receipt of chemotherapy during initial treatment. These findings should be considered when patients decide whether to receive adjuvant chemotherapy, particularly when expected benefit is low.