TY - JOUR
T1 - Impact of breast cancer treatment on employment
T2 - Results of a multicenter prospective cohort study (CANTO)
AU - Dumas, Agnes
AU - Luis, Ines Vaz
AU - Bovagnet, Thomas
AU - El Mouhebb, Mayssam
AU - Di Meglio, Antonio
AU - Pinto, Sandrine
AU - Charles, Cecile
AU - Dauchy, Sarah
AU - Delaloge, Suzette
AU - Arveux, Patrick
AU - Coutant, Charles
AU - Cottu, Paul
AU - Lesur, Anne
AU - Lerebours, Florence
AU - Tredan, Olivier
AU - Vanlemmens, Laurence
AU - Levy, Christelle
AU - Lemonnier, Jerome
AU - Mesleard, Christelle
AU - Andre, Fabrice
AU - Menvielle, Gwenn
N1 - Publisher Copyright:
© 2019 by American Society of Clinical Oncology.
PY - 2020/3/1
Y1 - 2020/3/1
N2 - PURPOSE Adverse effects of breast cancer treatment can negatively affect survivors' work ability. Previous reports lacked detailed clinical data or health-related patient-reported outcomes (PROs) and did not prospectively assess the combined impact of treatment and related sequelae on employment. METHODS We used a French prospective clinical cohort of patients with stage I-III breast cancer including 1,874 women who were working and ≥ 5 years younger than legal retirement age (≤ 57 years) at breast cancer diagnosis. Our outcome was nonreturn to work (non-RTW) 2 years after diagnosis. Independent variables included treatment characteristics as well as toxicities (Common Toxicity Criteria Adverse Events [CTCAE] v4) and PROs (European Organization for Research and Treatment of Cancer [EORTC] Quality of life Questionnaires, Breast cancer module [QLQ-BR23] and Fatigue module [QLQ-FA12], Hospital Anxiety and Depression Scale) collected 1 year after diagnosis. Logistic regression models assessed correlates of non-RTW, adjusting for age, stage, comorbidities, and socioeconomic covariates. RESULTS Two years after diagnosis, 21%of patients had not returned to work. Odds of non-RTWwere significantly increased among patients treated with combinations of chemotherapy and trastuzumab (odds ratio [OR] v chemotherapy-hormonotherapy: For chemotherapy-trastuzumab, 2.01; 95% CI, 1.18 to 3.44; for chemotherapytrastuzumab- hormonotherapy, 1.62; 95%CI, 1.10 to 2.41). Other significant associations with non-RTW included grade ≥ 3 CTCAE toxicities (OR v no, 1.59; 95% CI, 1.15 to 2.18), arm morbidity (OR v no, 1.59; 95% CI, 1.19 to 2.13), anxiety (OR v no, 1.47; 95% CI, 1.02 to 2.11), and depression (OR v no, 2.29; 95% CI, 1.34 to 3.91). CONCLUSION Receipt of systemic therapy combinations including trastuzumab was associated with increased odds of non-RTW. Likelihood of unemployment was also higher among patients who reported severe physical and psychological symptoms. This comprehensive study identifies potentially vulnerable patients and warrants supportive interventional strategies to facilitate their RTW.
AB - PURPOSE Adverse effects of breast cancer treatment can negatively affect survivors' work ability. Previous reports lacked detailed clinical data or health-related patient-reported outcomes (PROs) and did not prospectively assess the combined impact of treatment and related sequelae on employment. METHODS We used a French prospective clinical cohort of patients with stage I-III breast cancer including 1,874 women who were working and ≥ 5 years younger than legal retirement age (≤ 57 years) at breast cancer diagnosis. Our outcome was nonreturn to work (non-RTW) 2 years after diagnosis. Independent variables included treatment characteristics as well as toxicities (Common Toxicity Criteria Adverse Events [CTCAE] v4) and PROs (European Organization for Research and Treatment of Cancer [EORTC] Quality of life Questionnaires, Breast cancer module [QLQ-BR23] and Fatigue module [QLQ-FA12], Hospital Anxiety and Depression Scale) collected 1 year after diagnosis. Logistic regression models assessed correlates of non-RTW, adjusting for age, stage, comorbidities, and socioeconomic covariates. RESULTS Two years after diagnosis, 21%of patients had not returned to work. Odds of non-RTWwere significantly increased among patients treated with combinations of chemotherapy and trastuzumab (odds ratio [OR] v chemotherapy-hormonotherapy: For chemotherapy-trastuzumab, 2.01; 95% CI, 1.18 to 3.44; for chemotherapytrastuzumab- hormonotherapy, 1.62; 95%CI, 1.10 to 2.41). Other significant associations with non-RTW included grade ≥ 3 CTCAE toxicities (OR v no, 1.59; 95% CI, 1.15 to 2.18), arm morbidity (OR v no, 1.59; 95% CI, 1.19 to 2.13), anxiety (OR v no, 1.47; 95% CI, 1.02 to 2.11), and depression (OR v no, 2.29; 95% CI, 1.34 to 3.91). CONCLUSION Receipt of systemic therapy combinations including trastuzumab was associated with increased odds of non-RTW. Likelihood of unemployment was also higher among patients who reported severe physical and psychological symptoms. This comprehensive study identifies potentially vulnerable patients and warrants supportive interventional strategies to facilitate their RTW.
UR - http://www.scopus.com/inward/record.url?scp=85080056977&partnerID=8YFLogxK
U2 - 10.1200/JCO.19.01726
DO - 10.1200/JCO.19.01726
M3 - Article
C2 - 31834818
AN - SCOPUS:85080056977
SN - 0732-183X
VL - 38
SP - 734
EP - 743
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 7
ER -