Return to work after breast cancer: Comprehensive longitudinal analyses of its determinants.

Authors

null

Agnes Dumas

Institut Gustave Roussy, Villejuif, France

Agnes Dumas , Ines Maria Vaz Duarte Luis , Thomas Bovagnet , Antonio Di Meglio , Mayssam El-Mouhebb , Sandrine Pinto , Cecile Charles , Sarah Dauchy , Charles Coutant , Paul H. Cottu , Anne Lesur , Florence Lerebours , Olivier Tredan , Laurence Vanlemmens , Christelle Levy , Jerome Lemonnier , Christel Mesleard , Patrick Arveux , Fabrice Andre , Gwenn Menvielle

Organizations

Institut Gustave Roussy, Villejuif, France, Dana-Farber Cancer Institute, Boston, MA, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France, Gustave Roussy, Villejuif, France, INSERM, Paris, France, Institut Gustave Roussy, Department of Psycho Oncology, Villejuif, France, Centre Georges-François Leclerc, Dijon, France, Institut Curie, Paris, France, Institut de Cancérologie de Lorraine, Vandœuvre-Les- Nancy, France, Département d'Oncologie Médicale, Centre Léon Bérard, Lyon, France, Centre Oscar Lambret, Lille, France, Centre François Baclesse, Department of Medical Oncology, Caen, France, Unicancer, Paris, France, R&D Unicancer, Paris, France, Biostatistics and Quality of Life Unit, Centre Georges François Leclerc and EA 4184, Dijon, France

Research Funding

Other Foundation
Other Foundation, French National Agency for Research (ANR)

Background: The interplay between breast cancer (BC) late effects, psychosocial and work-related factors in return to work (RTW) is not well understood. Previous reports were retrospective and did not combine all these features. Methods: We used data of a French prospective cohort study (CANTO, NCT01993498) of stage I-III BC patients (pts) including detailed clinical data of 1,874 pts working at diagnosis (dx) and ≥5 years younger than legal retirement age. The outcome was non-RTW 2 years after dx. Multivariable regressions were conducted to identify correlates of non-RTW. First, we examined the independent effect of treatments, toxicities (Common Toxicity Criteria Adverse Events), and patient reported outcomes (EORTC BR23 and FA12; Hospital Anxiety and Depression Scale) collected shortly after end of primary treatment. Then, in a restricted sample of 1,003 pts with working conditions (WC) information available, we fitted models to account for detailed pre-dx WC including type of contract, working hours, strenuous postures, supportive environment, degree of autonomy and perception of work. All models were adjusted for age, stage, marital status, socioeconomic status and comorbidities. Results: Two years after dx, 21% of pts did not work. Adjusted odds of non-RTW were increased among pts treated with combinations of chemotherapy (CT) and trastuzumab (TR) (e.g. OR of CT-TR = 2.20 [95% CI 1.24-3.88] and OR of CT-TR-hormonotherapy (HT) = 1.72 [1.13-2.63] vs. treated only with CT-HT), who had severe arm morbidity (OR = 1.73 [1.27-2.36] vs. no), severe emotional fatigue (OR = 1.55 [1.03-2.32] vs. no), anxiety (OR = 1.51 [1.02-2.23] vs. no), or depression (OR = 2.23 [1.27-3.94] vs no). In addition, we also found that the odds of non-RTW were increased among pts who had shift working hours (OR = 2.23 [1.32-3.76] vs. no), who did not work in a supportive environment before dx (OR = 2.24 [1.44-3.50] vs. supportive) and who perceived their job as boring (OR = 3.57 [1.71-7.46] vs. not boring). Conclusions: More than 1/5 of pts did not RTW 2 years after dx, with treatment (trastuzumab), clinical, psychological and work-related factors being associated with job reintegration. Multidisciplinary strategies are needed to support BC survivors.

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Abstract Details

Meeting

2019 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Symptoms and Survivorship

Track

Symptom Science and Palliative Care

Sub Track

Late and Long-Term Adverse Effects

Citation

J Clin Oncol 37, 2019 (suppl; abstr 11564)

DOI

10.1200/JCO.2019.37.15_suppl.11564

Abstract #

11564

Poster Bd #

256

Abstract Disclosures