30% of breast cancer survivors unemployed 4 years after treatment

Nearly one-third of breast cancer survivors who were employed when they started treatment reported that they were unemployed 4 years later, with chemotherapy recipients being most likely to report unemployment.

“Many doctors believe that even though patients may miss work during treatment, they will ‘bounce back’ in the longer term. The results of this study suggest otherwise. Loss of employment is a possible long-term negative consequence of chemotherapy that may not have been fully appreciated to date,” Reshma Jagsi, MD, DPhil, associate professor of radiation oncology at the University of Michigan Medical School, said in a press release. “We also need to ensure that patients who are deciding on whether to receive chemotherapy understand the potential long-term consequences of receiving treatment, including possible implications for their employment and financial outcomes.”

To assess the long-term effect of chemotherapy on employment and whether certain subgroups of patients are particularly vulnerable to employment loss during the long-term survivorship period, Jagsi and colleagues surveyed woman in Detroit and Los Angeles who had been diagnosed with early stage breast cancer and reported through the SEER program registries.

Among 3,133 surveyed patients with breast cancer, 2,290 (73%) completed a baseline survey soon after diagnosis; of these, 1,536 (67%) completed the 4-year follow-up questionnaire.

According to study results, the researchers observed that among 1,026 patients who experienced breast cancer recurrence and had responded to both surveys, 76% had worked for pay prior diagnosis. However, of these patients, 30% were no longer employed at the time of the follow-up survey.

Additionally, patients 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).

In a multivariable model, researchers noted that chemotherapy receipt at the time of diagnosis (OR=1.4; P=.04) was independently associated with unemployment during survivorship. Patients who were not employed during the survivorship period expressed a desire to work: 50% reported that it was important for them to work and 31% were actively seeking employment.

“The results of the current study suggest that loss of paid employment after a diagnosis of breast cancer may be common, often undesired, not restricted to the treatment period, and potentially related to the type of treatment administered,” Jagsi and colleagues wrote. “The findings reported here support current efforts to reduce the morbidity and burden of treatments for breast cancer. Indeed, such initiatives are actively being evaluated, including better strategies to identify those patients who might omit adjuvant chemotherapy because the marginal benefit is small.”

Disclosure: The researchers reported honoraria and employment relationships with eviti Inc. and AbbVie Pharmaceuticals.