After Aggressive Breast Cancer Surgery, Women Miss More Work

A new study reveals that patients with breast cancer who received more aggressive treatments were more likely to experience disruptions in employment.

Published early online in CANCER, a peer-reviewed journal of the American Cancer Society, the findings may be helpful for patients who are comparing their options for breast cancer treatment.

Many women with breast cancer are working at the time of diagnosis and would benefit from understanding how their treatment decisions might affect their employment. To examine how employment experiences are impacted by different types of breast cancer treatment, Reshma Jagsi, MD, DPhil, of the University of Michigan, and her colleagues surveyed women aged 20 to 79 years diagnosed with stages 0-II breast cancer as reported to the Georgia and Los Angeles SEER registries in 2014 and 2015. The investigators analyzed 1006 women who were reportedly working before their diagnosis.

Among the surveyed women, 62 percent underwent a lumpectomy to remove their tumors, 16 percent had a unilateral mastectomy (8 percent with reconstruction), and 23 percent had a bilateral mastectomy (19 percent with reconstruction). One-third of women received chemotherapy. Most (84 percent) worked full time before diagnosis.

The study's findings also revealed that women who underwent bilateral mastectomy with reconstruction had nearly eight times the risk of missing over a month of work, as compared with those who underwent lumpectomy. Also, women who missed more than a month of work often lost substantial income; 29 percent of these women lost more than $5000.

"Prior studies have shown that most of the women who had bilateral mastectomy could have chosen lumpectomy but chose the more aggressive surgery, often out of a desire to improve peace of mind. This study helps to quantify the impact of this decision on the employment and financial experiences of those women soon after diagnosis," said Dr. Jagsi. "The impact of treatment on employment and finances is a consideration that women may wish to take into account when weighing the pros and cons of various surgical options they are considering."