Background: Breast cancer (BC) can negatively impact employment, risking healthcare benefits, financial security and quality of life, especially for underserved minority populations. To better understand the impact of BC diagnosis and treatment on employment, Breastcancer.org conducted an online survey. Methods: Between 6/7-7/12/2022, Breastcancer.org community members were recruited to participate in an anonymous survey in English or Spanish via email, social media, or website ads. Eligible participants were US residents, age ≥18, and diagnosed with BC within the past 10 years. Consented participants answered questions on socio-demographics, financial toxicity, and employment status. Results: Of 2,420 screened, 1,710 met eligibility, and 1,437 participated (84% participation rate). Mean age and time since diagnosis was 46 and 2 years, respectively; 75% were in active treatment for non-metastatic (89%) or metastatic (11%) BC. Patients identified as 60% White (n=868), 26.7% Hispanic (n=384), 8% Black (n=121), or 4% Other (n=64). 94% were women. BC negatively impacted employment for 92% of patients. Full-time employment went from 62% at diagnosis to 40% by the time of the survey. This was more pronounced in metastatic (56% to 25%) vs non-metastatic (63% to 42%) patients (p=0.015). 64% attributed employment changes to their diagnosis, noting reduced hours/income (40%), job change (26%), disability (13%), permanent job loss (13%), and/or early retirement (12%). 36% noted changes in their caregiver’s employment status as well with 30% of caregivers having reduced hours/income, 30% taking time off work, and 27% changing jobs; 9% of caregivers had permanent job loss and 10% retired early. Hispanic patients were younger (p<0.001) and more likely to have young children (p<0.001) and take unpaid leave (p=0.02). (Table). BC diagnosis was also more likely to impact their caregiver’s employment (58%, vs White 25% or Black 41% patients, p<0.001). Conclusions: Breast cancer can cause significant, lasting negative effects on employment status for patients and caregivers that can decrease financial security of the entire family unit. Hispanic patients and individuals with metastatic disease appear to be at highest risk. Legislative protections and financial support may be required to mitigate the significant financial toxicity of a cancer diagnosis, especially for the most vulnerable.

* p≤0.05.