Breast Cancer Treatment May Affect Patients' Long-Term Employment

Reshma Jagsi, MD, DPhil

Patients who received adjuvant chemotherapy as treatment for their breast cancer were less likely to be working after their treatment compared with patients who were not treated with adjuvant chemotherapy, a new study suggests.

The study, published early online in Cancer, was led by Reshma Jagsi, MD, of the University of Michigan Health System.

The study enrolled 2290 women in the Los Angeles and Detroit areas who were diagnosed with nonmetastatic breast cancer between 2005 and 2007 and who completed surveys soon after diagnosis; 1536 of the women also completed a 4-year follow-up questionnaire.

Women who received chemotherapy as part of initial treatment were less likely to be working at the 4-year follow-up than women who were not treated with chemotherapy (38% vs 27%).

Of the 1026 patients under age 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.

The study showed that women who received chemotherapy at the time of diagnosis were 1.4 times more likely to be subsequently unemployed. The study also found that many women who were not employed after treatment wanted to work, with 50% saying that it was important for them to work and 31% saying they were actively seeking work.

“Many clinicians believe that although patients may miss work during treatment, they will ‘bounce back’ in the longer term. The results of this study suggest otherwise and highlight a possible long-term adverse consequence to adjuvant chemotherapy that may not have been fully appreciated to date,” Jagsi said in a statement.“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.”

The results of this study also support efforts to reduce the side effects and burden of treatments for breast cancer and to identify patients who may forego certain treatments, particularly when the expected benefit is low.