Background: Workplace concerns are particularly salient for young women with breast cancer (BC), and a cancer diagnosis (dx) and treatment may affect their careers. We sought to evaluate the perceived impact of dx on employment, describe job changes, and identify factors associated with transition out of the workforce after dx of BC at a young age.

Methods: As part of an ongoing, multi-center cohort of young women diagnosed with BC at age ≤ 40, we surveyed women with early-stage BC about their pre- and post-dx employment status. Additional items assessed socio-demographic and treatment information; tumor characteristics were ascertained via pathology and medical record review. We used logistic regression to identify predictors of transitioning from pre-dx employment to unemployment at 1 year after dx. Among women employed 1 year after dx, we evaluated job satisfaction, perceived impact of dx on job performance, accommodations made by employers, and perceived likelihood of employment in the future.

Results: 76% of women (555/730) were employed both before dx and at 1 year; 13% were not employed at either time point; 7% were employed pre-dx but unemployed at 1 year; 4% were not employed prior to dx but reported employment at 1 year. Among women employed 1 year after dx, 74% (427/581) were somewhat or completely satisfied with their job. Only 6% said cancer or treatment limited their ability to perform their job quite a bit or very much; 38% said their ability was affected a little bit. Most (63%) said their employers had made accommodations for them, and almost all women (93%) said it was very likely they would be working in 1 year. In multivariable analyses (Table 1), women with stage 3 disease (vs. stage 1), were more likely to transition out of the workforce following dx, while women with a college or graduate degree (vs. no college degree) were less likely to transition out.

Conclusion: Most young women with early stage BC remain employed and report a willingness by their employer to make accommodations following a breast cancer dx. While few women reported that their dx or treatment limited their job performance, the finding that women with more advanced disease were more likely to transition out of the workforce suggests an impact of dx/treatment burden on employment. Women without a college degree were also at risk for unemployment post-dx, suggesting that job type, socioeconomic status, and environment affect employment outcomes. Attention to these subgroups of women is warranted to ensure that they are sufficiently supported given the potential adverse psychosocial and financial impacts of unemployment on patients, families, communities, and society.

Table 1. Multivariable analysis of factors associated with transition out of workforce 1year post-dx (N=634)

  OR (95% CI) 
Stage (ref=1)   
4.52 (0.60-33.85) 
1.11 (0.48-2.58) 
4.05 (1.53-10.72)* 
White non-Hispanic (ref=non-WNH) 1.47 (0.56-3.81) 
College graduate (ref=no college degree) 0.44 (0.22-0.90)* 
Married/Living as married (ref=unmarried) 0.95 (0.43-2.08) 
Parous (ref=nulliparous) 1.75 (0.83-3.69) 
Age at diagnosis (years) 0.98 (0.90-1.06) 
Mastectomy (ref=lumpectomy) 1.74 (0.75-4.05) 
Endocrine therapy (ref=none) 0.75 (0.41-1.39) 
Chemotherapy (ref=none) 5.20 (0.93-29.22) 
Radiation (ref=none) 1.38 (0.64-2.96) 
  OR (95% CI) 
Stage (ref=1)   
4.52 (0.60-33.85) 
1.11 (0.48-2.58) 
4.05 (1.53-10.72)* 
White non-Hispanic (ref=non-WNH) 1.47 (0.56-3.81) 
College graduate (ref=no college degree) 0.44 (0.22-0.90)* 
Married/Living as married (ref=unmarried) 0.95 (0.43-2.08) 
Parous (ref=nulliparous) 1.75 (0.83-3.69) 
Age at diagnosis (years) 0.98 (0.90-1.06) 
Mastectomy (ref=lumpectomy) 1.74 (0.75-4.05) 
Endocrine therapy (ref=none) 0.75 (0.41-1.39) 
Chemotherapy (ref=none) 5.20 (0.93-29.22) 
Radiation (ref=none) 1.38 (0.64-2.96) 

*p<0.05

Citation Format: Partridge AH, Rosenberg SM, Rajagopal PS, Ruddy KJ, Tamimi RM, Schapira L, Come S, Borges V, Gelber S. Employment trends in young women following a breast cancer diagnosis. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P4-10-04.