Physicians counseling patients about breast cancer therapeutic options should inform patients about the financial effects of missed work related to treatment, according to research published in Cancer.1

The relationship between financial toxicity and missed work due to breast cancer treatment is not fully established, with previous studies offering different conclusions. The number of treatment options — coupled with the sometimes-overaggressive therapies used — suggests a need for integration of the potential financial effects of missed work into patient counseling after a breast cancer diagnosis.

For this observational study, researchers reviewed the health and financial data of 1006 women living in Georgia or Los Angeles who were diagnosed with breast cancer in 2014-15. Over half (55%) of the included patients were 51 to 65 years old. Most patients (84%) were full-time employees at diagnosis; 50% had paid sick leave, 39% had disability benefits, and 38% had a flexible work schedule.

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One-third of patients received chemotherapy, 52% received radiotherapy, and surgical operations included the following: lumpectomy (62%), unilateral mastectomy without reconstruction (8%), unilateral mastectomy with reconstruction (8%), bilateral mastectomy without reconstruction (4%), and bilateral mastectomy with reconstruction (19%).

Patients with flexible work schedules and paid sick leave were less likely to leave employment, with odds ratios (ORs) of 0.3 and 0.5, respectively. Compared with lumpectomy, patients who underwent bilateral mastectomy with reconstruction were more than 3 times as likely to leave employment (OR, 3.1).

Patients who received chemotherapy were nearly 4 times as likely to leave employment as others (OR, 3.9), suggesting that the intensity of treatment is linked to the likelihood of leaving employment.

The authors concluded that “the potential impact on employment outcomes and the financial impact quantified in this study merit discussion to ensure that patients make choices fully informed about potential consequences.”

Reference

  1. Jagsi R, Abrahamse PH, Lee KL, et al. Treatment decisions and employment of breast cancer patients: results of a population-based survey. Cancer. 2017 Oct 9. doi: 10.1002/cncr.30959 [Epub ahead of print]