Treatment decisions and employment of breast cancer patients: Results of a population‐based survey

Abstract

Background Many patients with breast cancer work for pay at time of diagnosis, and the treatment plan may threaten their livelihood. Understanding work experiences in a contemporary population-based sample is necessary to inform initiatives to reduce the burden of cancer care. Methods We surveyed women aged 20–79 years diagnosed with stages 0–II breast cancer as reported to the Georgia and Los Angeles SEER registries in 2014–15. Of 3672 eligible women, 2502 responded (68%); we analyzed 1006 who reported working before diagnosis. Multivariable models evaluated correlates of missing >1 month and stopping work altogether vs missing ≤1 month. Results In this diverse sample, most patients (62%) received lumpectomy; 16% had unilateral mastectomy (8% with reconstruction); 23% had bilateral mastectomy (19% with reconstruction). One third (33%) received chemotherapy. Most (84%) worked full-time before diagnosis, but only 50% had paid sick leave, 39% disability benefits, and 38% flexible work schedules. Surgical treatment was strongly correlated with missing >1 month of work (OR 7.8 for bilateral mastectomy with reconstruction vs lumpectomy) and with stopping altogether (OR 3.1 for bilateral mastectomy with reconstruction vs lumpectomy). Chemotherapy receipt (OR 1.3 for missing >1 month; OR 3.9 for stopping altogether) and race (OR 2.0 for missing >1 month; OR 1.7 for stopping altogether; blacks vs whites) also correlated. Those with paid sick leave were less likely to stop working (OR 0.5), as were those with flexible schedules (OR 0.3). Conclusions Working patients who received more aggressive treatments were more likely to experience substantial employment disruptions.

Predictors of resignation and sick leave after cancer diagnosis among Japanese breast cancer survivors

“…The distinction between BCSs who underwent surgery and who do not mean those who have advanced stage or not, because, except for stage IV where distant metastasis is apparent, almost all BCSs experience surgery in general. Previous studies reported that breast cancer surgery was associated with SL lasting 1 month or longer (39,40), while median duration of hospitalization among BCSs were reported to be about 6.79-10.37 days in Japan (41). Surgical treatment may result in challenging sequelae including scar pain and reduced range of motion, particularly in the arm and chest region, fatigue, and lymphedema; these symptoms increase the time to RTW and are related to unemployment(41).…”

Predictors of resignation and sick leave after cancer diagnosis among Japanese breast cancer survivors

“…The distinction between BCSs who underwent surgery and who do not mean those who have advanced stage or not, because, except for stage IV where distant metastasis is apparent, almost all BCSs experience surgery in general. Previous studies reported that breast cancer surgery was associated with SL lasting 1 month or longer [42,43], while median duration of hospitalization among BCSs were reported to be about 6.79-10.37 days in Japan [44]. Surgical treatment may result in challenging sequelae including scar pain and reduced range of motion, particularly in the arm and chest region, fatigue, and lymphedema; these symptoms increase the time to RTW and are related to unemployment [44].…”

Predictors of resignation and sick leave after cancer dianosis among Japanese breast cancer survivors: a cross-sectional study

“…The distinction between BCSs who undergo surgery and those who do not suggests a relation to cancer stage (early or advanced) because almost all BCSs undergo surgery, except for those with stage IV cancer, in which distant metastasis is apparent. Previous studies have reported that breast cancer surgery is associated with SL lasting 1 month or longer [42,43], and that the median duration of hospitalization among BCSs in Japan is about 6.79-10.37 days [44]. Surgical treatment may result in challenging sequelae, including scar pain, fatigue, lymphedema, and reduced range of motion, particularly in the arm and chest region; these symptoms increase the time to RTW and are related to unemployment [45].…”