Journal
CANCER
Volume 120, Issue 12, Pages 1854-1862Publisher
WILEY-BLACKWELL
DOI: 10.1002/cncr.28607
Keywords
employment; breast cancer; chemotherapy; survivorship; work; survey; Surveillance; Epidemiology; End Results (SEER)
Categories
Funding
- National Cancer Institute (NCI) [R01 CA109696, R01 CA088370]
- American Cancer Society [MRSG-09-145-01]
- NCI [K05CA111340]
- California Department of Public Health as part of the statewide cancer reporting program [103885]
- NCI's Surveillance, Epidemiology, and End Results (SEER) program [N01-PC-35139]
- University of Southern California [N01-PC-54404]
- Centers for Disease Control and Prevention's National Program of Cancer Registries [1U58DP00807-01]
- NCI SEER program [N01-PC-35145]
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BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. (C) 2014 American Cancer Society.
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