Correlates of Return to Work for Breast Cancer Survivors

2006 ◽  
Vol 24 (3) ◽  
pp. 345-353 ◽  
Author(s):  
Reynard R. Bouknight ◽  
Cathy J. Bradley ◽  
Zhehui Luo

PurposeTo identify correlates of return to work for employed breast cancer survivors.Patients and MethodsPatients included 416 employed women with newly diagnosed breast cancer identified from the Metropolitan Detroit Cancer Surveillance System. Patients were interviewed by telephone 12 and 18 months after diagnosis. Correlates of return to work at 12 and 18 months were identified using multivariate logistic regression.ResultsMore than 80% of patients returned to work during the study period, and 87% reported that their employer was accommodating to their cancer illness and treatment. After adjusting for demographic characteristics, health status, cancer stage, treatment, and job type, heavy lifting on the job (odds ratio = 0.42; 95% CI, 0.18 to 0.99), perceived employer accommodation for cancer illness and treatment (odds ratio = 2.2; 95% CI, 1.03 to 4.8), and perceived employer discrimination because of a cancer diagnosis (odds ratio = 0.27; 95% CI, 0.10 to 0.71) were independently associated with return to work at 12 months after breast cancer diagnosis, and perceived employer accommodation (odds ratio = 2.3; 95% CI, 1.06 to 5.1) was independently associated with return to work at 18 months after breast cancer diagnosis.ConclusionA high percentage of employed breast cancer patients returned to work after treatment, and workplace accommodations played an important role in their return. In addition, perceived employer discrimination because of cancer was negatively associated with return to work for breast cancer survivors. Employers seem to have a pivotal role in breast cancer patients' successful return to work.

2020 ◽  
Author(s):  
Kiyomi Mitsui ◽  
Motoki Endo ◽  
Yuya Imai ◽  
Yuito Ueda ◽  
Hiroko Ogawa ◽  
...  

Abstract Background The number of breast cancer patients of working age is increasing in Japan . Consequently, there is a need for support for working individuals concomitantly undergoing breast cancer treatment. The present study aimed to clarify the risk factors for resignation and taking sick leave among breast cancer survivors in continued employment at the time of diagnosis. Methods As part of a Japanese national research project (Endo-Han), the investigators conducted a web-based survey of cancer survivors (CSs) in 2018. The investigators analyzed the risk factors for post-breast cancer diagnosis resignation and sick leave using a logistic regression model, including age at diagnosis, educational level, cancer stage, surgery, pharmacotherapy, radiotherapy, employment status, and occupational type. Results 40 of 269 breast cancer survivors (14.9%) quit their job after cancer diagnosis. Predictors of resignation included lower education level (odds ratio [OR]: 3.802; 95%CI: 1.233-11.729), taking sick leave (OR: 2.514; 95%CI: 1.202-5.261), and younger age at diagnosis (OR: 0.470; 95%CI: 0.221-0.998). Of 229 patients who continued working, sick leave was taken by 72 (31.4%); having surgery was a predictor for taking sick leave (OR: 8.311; 95%CI: 1.007-68.621). Conclusions 14.9% of Japanese employees quit their jobs after being diagnosed with breast cancer. Being younger at breast cancer diagnosis, having lower educational attainment level, and utilizing sick leave were identified as predictors of post-cancer diagnosis resignation. Surgery was associated with the highest risk of taking sick leave. Breast cancer survivors exhibit higher risks for resignation, and may require more carefully follow-up after diagnosis by healthcare providers and employers to protect work sustainability.


2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 119s-119s
Author(s):  
Y.-C. Kong ◽  
N.T. Bhoo-Pathy ◽  
L.-P. Wong ◽  
A.F. Aziz ◽  
N.A. Taib ◽  
...  

Background: Cancer survivorship as an area, which focuses on the health and life of an individual following cancer diagnosis and treatment is increasingly being recognized as an important component of the cancer control continuum. Advances in breast cancer detection and treatments have resulted in a growing number of patients experiencing a breast cancer diagnosis at an age when career plays an important role in their lives. Yet, very little is known on how breast cancer affects employment and return to work among survivors, particularly in low- and middle-income settings. Aim: This qualitative study aims to gain an in-depth understanding on employment challenges and motivators/barriers in return to work faced by breast cancer survivors in an upper-middle income Asian setting. Methods: Eleven focus group discussions (FGDs) were conducted with breast cancer survivors representing various ethnicities and socioeconomic backgrounds in Malaysia. Patients diagnosed one to two years prior to the study were recruited from a general public hospital, a public academic hospital and two private hospitals. Data from the FGDs were examined using thematic content analysis from the NVivo software. Results: The major themes relating to impact of cancer diagnosis on employment were “decreased work ability”, “job loss”, “long absenteeism” and “hostile work environment”. Coping strategy themes frequently mentioned to offset income loss from employment changes were “savings”, “part-time work” or financial support from “family/friends” or “social security”. However, participants were quick to highlight the insufficiency and unreliability of these strategies to cope financially in the long run. When describing their decision in choosing to return to work, participants mentioned themes such as “need money”, feeling “more happy” or having a “supportive work environment”. Nonetheless, participants emphasized the “discrimination” they faced in finding a job after active treatment. Specifically, participants' frequent need to take time-off from work for their cancer follow-ups as well as their older age were perceived as disadvantages in seeking employment when compared with younger, healthy applicants. Conclusion: It is evident that a breast cancer diagnosis severely disrupts employment and return to work in middle income settings. Multisectoral interventions are urgently required to improve the employment status of our cancer survivors, including legislative reforms to prevent discrimination. Programs supporting employment and return to work among cancer survivors should be developed and integrated in the provision of a holistic survivorship care.


2020 ◽  
Author(s):  
Kiyomi Mitsui ◽  
Motoki Endo ◽  
Yuya Imai ◽  
Yuito Ueda ◽  
Hiroko Ogawa ◽  
...  

Abstract Background The number of breast cancer patients of working age is increasing in Japan . Consequently, there is a need for support for working individuals concomitantly undergoing breast cancer treatment. The present study aimed to clarify the risk factors for resignation and taking sick leave among breast cancer survivors in continued employment at the time of diagnosis. Methods As part of a Japanese national research project (Endo-Han), the investigators conducted a web-based survey of cancer survivors (CSs) in 2018. The investigators analyzed the risk factors for post-breast cancer diagnosis resignation and sick leave using a logistic regression model, including age at diagnosis, educational level, cancer stage, surgery, pharmacotherapy, radiotherapy, employment status, and occupational type. Results 40 of 269 breast cancer survivors (14.9%) quit their job after cancer diagnosis. Predictors of resignation included lower education level (odds ratio [OR]: 3.802; 95%CI: 1.233-11.729), taking sick leave (OR: 2.514; 95%CI: 1.202-5.261), and younger age at diagnosis (OR: 0.470; 95%CI: 0.221-0.998). Of 229 patients who continued working, sick leave was taken by 72 (31.4%); having surgery was a predictor for taking sick leave (OR: 8.311; 95%CI: 1.007-68.621). Conclusions 14.9% of Japanese employees quit their jobs after being diagnosed with breast cancer. Being younger at breast cancer diagnosis, having lower educational attainment level, and utilizing sick leave were identified as predictors of post-cancer diagnosis resignation. Surgery was associated with the highest risk of taking sick leave. Breast cancer survivors exhibit higher risks for resignation, and may require more carefully follow-up after diagnosis by healthcare providers and employers to protect work sustainability.


2021 ◽  
pp. 1-6
Author(s):  
Danbee Kang ◽  
Nayeon Kim ◽  
Gayeon Han ◽  
Sooyeon Kim ◽  
Hoyoung Kim ◽  
...  

Abstract Objective This study aims to identify factors associated with divorce following breast cancer diagnosis and measures the impact of divorce on the quality of life (QoL) of patients. Methods We used cross-sectional survey data collected at breast cancer outpatient clinics in South Korea from November 2018 to April 2019. Adult breast cancer survivors who completed active treatment without any cancer recurrence at the time of the survey (N = 4,366) were included. The participants were classified into two groups: “maintaining marriage” and “being divorced,” between at the survey and at the cancer diagnosis. We performed logistic regression and linear regression to identify the factors associated with divorce after cancer diagnosis and to compare the QoL of divorced and nondivorced survivors. Results Approximately 11.1/1,000 of married breast cancer survivors experienced divorce after cancer diagnosis. Younger age, lower education, and being employed at diagnosis were associated with divorce. Being divorced survivors had significantly lower QoL (Coefficient [Coef] = −7.50; 95% CI = −13.63, −1.36), social functioning (Coef = −9.47; 95% CI = −16.36, −2.57), and body image (Coef = −8.34; 95% CI = −6.29, −0.39) than survivors who remained married. They also experienced more symptoms including pain, insomnia, financial difficulties, and distress due to hair loss. Conclusion Identifying risk factors of divorce will ultimately help ascertain the resources necessary for early intervention.


2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 6531-6531 ◽  
Author(s):  
Kathryn Jean Ruddy ◽  
Lindsey R. Sangaralingham ◽  
Heather B. Neuman ◽  
Caprice Christian Greenberg ◽  
Rachel A. Freedman ◽  
...  

6531 Background: Annual mammography is recommended to screen residual breast tissue for new cancers and recurrent disease after treatment for early stage breast cancer. This study aimed to assess mammography rates over time in breast cancer survivors. Methods: We used administrative claims data from a large U.S. commercial insurance database, OptumLabs, to retrospectively identify privately- and Medicare Advantage-insured women with operable breast cancer who had residual breast tissue after definitive breast surgery between 2006 and 2015. We required coverage for at least 13 months following surgery. For each subsequent 13-month time period, we only included women without a loss of coverage, bilateral mastectomy, metastatic breast cancer diagnosis, or non-breast cancer diagnosis. We calculated the proportion of patients who had a mammogram during each 13-month period following breast surgery. We used multivariable logistic regression to test for factors associated with mammography in the first 13 months. Results: The cohort included 26,011 women followed for a median of 2.9 years (IQR 1.9-4.6) after surgery; 63.1% were less than 65 years of age, and 74.4% were white. In their first year of follow-up, 86% underwent mammography, but by year 7, this decreased to 73%. Fewer than 1% underwent MRI instead of mammography. In multivariable analysis, mammograms were less likely during the first year after surgery among women aged < 50 years (odds ratio [OR], 0.7; 95% confidence interval [CI], 0.6 to 0.8), African Americans (OR, 0.7; 95% CI, 0.7 to 0.8), patients who underwent mastectomy (OR, 0.7; 95% CI, 0.6 to 0.7), and patients residing in the Western part of the country (OR, 0.9; 95% CI, 0.7 to 0.9). Those with 1-2 comorbidities were more likely (OR, 1.1; 95% CI 1.1-1.2) than those with none to have a mammogram during that period. Mammography use did not differ significantly by year of diagnosis (2006-2015). Conclusions: Even in an insured cohort, a substantial proportion of breast cancer survivors do not undergo annual surveillance mammography. Mammography use falls as the time from the early stage breast cancer diagnosis increases. Understanding factors associated with lack of mammographic screening may help improve survivorship care.


2021 ◽  
Author(s):  
Juhua Luo ◽  
Stephen J. Carter ◽  
Elizabeth M Cespedes Feliciano ◽  
Michael Hendryx

Abstract PURPOSE: Aging associated with progressive declines in physical function is well-known; however, little is known about the trajectories of physical function before and after breast cancer diagnosis. The current study examined the trajectories in objective measures of physical function over 20 years for women with breast cancer and matched controls. METHODS: 2712 community-dwelling women (452 breast cancer cases and 1:5 matched cancer-free controls) aged 65 years or older at baseline (1986-1988) within the Study of Osteoporotic Fractures were followed for 20 years. Objective physical function was assessed up to 9 times, including hand-grip strength, timed chair stand, gait speed and quadriceps strength. Linear mixed models were used to model physical function changes in terms of secular time trend, group (cases or controls), period (pre-and post-diagnosis status), and their interaction terms. RESULTS: We observed all measures of physical function declined over time. While no differences in trends between cases and controls during the pre-diagnosis period were observed, after cancer diagnosis, grip strength and gait speed declined significantly faster in cases than controls. Quadriceps strength significantly decreased ~7 pounds shortly after breast cancer diagnosis, and then improved over time. CONCLUSION: Our prospective study revealed that older breast cancer survivors had significantly worse declines in grip strength and gait speed and a sharp, short-term drop followed by gradual improvement over time in quadriceps strength, compared to women without cancer. These findings suggest exercise training targeting muscle strength and mobility would be beneficial among older breast cancer survivors.


2020 ◽  
Vol 7 (7) ◽  
pp. 566-569
Author(s):  
Fatih Yıldız ◽  
Mehmet Erdem Alagüney

Objective: The effect of breast cancer on family life and marital status is one of the issues to investigate. Our aim in this study is to evaluate the frequency of divorce of breast cancer survivors and to investigate the demographic, disease, and treatment-related factors that may affect the divorce. Material and Methods: We performed this cross-sectional study between January 2020 and May 2020. Inclusion criteria were; women who were married at the time of breast cancer diagnosis, older than 18 years of age, and completed at least 6 months after breast cancer surgery and adjuvant chemotherapy/radiotherapy. The primary aim of this study was to find the marital dissolution rate of the patients after early-stage breast cancer diagnosis and adjuvant treatment. The secondary aim was to investigate the demographics and treatment-related factors affecting the marital status of breast cancer survivors. Results: The median age of 583 women included in the study was 47 (28-72). The median time to stay married was 291.0 months (min-max: 32.5-654.6). The most preferred surgical method in these patients was total mastectomy (n = 364, 62.4%). Adjuvant chemotherapy was applied to 505 (86.6%) patients, adjuvant endocrine therapy to 499 (85.6%) patients, and adjuvant radiotherapy to 460 (78.9%) patients. 21 (3.6%) patients divorced after diagnosis. In univariate analysis, surgery type, adjuvant chemotherapy, adjuvant radiotherapy, and adjuvant endocrine therapy were found to not affect the divorce. Conclusion: In our study, it was observed that the frequency of divorce was higher in breast cancer survivors than the general population, and breast surgery type and adjuvant treatments did not cause an increase in the risk of divorce.


2011 ◽  
Vol 29 (27_suppl) ◽  
pp. 210-210
Author(s):  
C. E. Hill-Kayser ◽  
C. Vachani ◽  
M. K. Hampshire ◽  
G. A. Di Lullo ◽  
J. M. Metz

210 Background: Breast cancer survivors may be at risk for significant late effects after treatment. Understanding the patterns of change over time of patient reported outcomes (PRO) is often very challenging. Methods: Patient-reported data was gathered via a convenience sample frame from breast cancer survivors utilizing a publically available, free, Internet-based tool for creation of survivorship care plans. Available at www.livestrongcareplan.com and through the OncoLink website, the tool allows survivors to enter data regarding diagnosis, demographics, treatments received, and late effects experienced, and provides them with customized guidelines for future care. All data has been maintained anonymously with IRB approval. Results: 1,145 breast cancer survivors were queried with regard to PRO. Median age at diagnosis (dx) was 49 yrs, and median current age 52 yrs. Of users, 98% reported having had surgery; of these 56% underwent mastectomy and 49% lumpectomy (5% both). Similarly, 59% underwent sentinel LN biopsy, and 47% axilary dissection. Of the same cohort, 88% received chemotherapy and/or hormonal treatment, and 70% radiation therapy. The median time from dx until use of the care plan tool was 2 years (range 0-33 years). Late effects reported by survivors ≤ 2 and > 2 years from diagnosis are shown (see table). Overall, survivors ≤ 2 years from dx were more likely to note changes in skin color or texture; those > 2 years from diagnosis were more likely to note osteopenia, lymphedema, and sexual changes. Patient reported cognitive changes, arm pain/numbness/tingling, and loss of shoulder flexibility did not differ between the two groups. Conclusions: This anonymous tool uses a convenience sample frame to gather PRO after breast cancer diagnosis/ treatment. PRO varied significantly with time since dx, with more late effects reported > 2 years from dx. This information may be of use during patient counseling and survivorship care delivery. [Table: see text]


2017 ◽  
Vol 35 (1) ◽  
pp. 38-43 ◽  
Author(s):  
Iris Lee ◽  
Sheila N Garland ◽  
Angela DeMichele ◽  
John T Farrar ◽  
Eun-Ok Im ◽  
...  

Introduction Treatment-related joint pain affects almost half of all women with breast cancer using aromatase inhibitors and is a major reason for terminating treatment. Although acupuncture is becoming an increasingly popular, evidence-based option for treating pain, little is known about the potential influence of psychological factors on acupuncture use. Objective We aimed to evaluate the association between pain catastrophising and use of acupuncture in breast cancer survivors experiencing arthralgia. Methods We conducted a cross-sectional survey of arthralgic breast cancer patients. Patients were asked if they had used acupuncture since their cancer diagnosis. The Pain Catastrophising Scale (PCS) was used to measure negative coping styles related to the experience of pain. We performed multiple logistic regression analysis to evaluate the relationship between pain catastrophising and acupuncture use, adjusting for covariates. Results Of the 424 participants, 69 (16%) reported use of acupuncture since their breast cancer diagnosis. In multivariate analyses, compared to those in the lowest PCS score tertile, patients with the highest PCS scores were more likely to have used acupuncture (p=0.03). In particular, patients with high levels of rumination (p=0.005) and magnification (p=0.008) were more likely to have used acupuncture. Helplessness was not associated with acupuncture use (p=0.23). Conclusions High levels of pain catastrophising, and specifically the processes of rumination and magnification, were associated with greater acupuncture use. We believe this could have important implications for understanding which population is more likely to seek acupuncture treatment and how this alternative therapy could be better targeted to these patients.


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