Abstract

PurposeTo identify subgroups of female breast cancer patients with distinct self-reported employment interference (EI) profiles and determine which demographic, clinical, and symptom characteristics, and quality of life outcomes were associated with subgroup membership.MethodsWomen with breast cancer (n = 385) were assessed for changes in EI over ten times, from prior to, through 12 months after breast cancer surgery. Latent profile analysis (LPA) was used to identify subgroups of patients with distinct EI profiles.ResultsThree distinct EI profiles (i.e., None – 26.2% (n = 101), Low – 42.6% (n = 164), High – 31.2% (n = 120)) were identified. Compared to the None and Low groups, patients in the High group were more likely to be younger. Higher proportions in the High group were non-White, pre-menopausal prior to surgery, had more advanced stage disease, had received an axillary lymph node dissection, had received neoadjuvant chemotherapy, had received adjuvant chemotherapy, and had a re-excision or mastectomy on the affected breast within 6 months after surgery. In addition, these patients had lower quality of life scores. Compared to the None group, the High group had higher levels of trait and state anxiety, depressive symptoms, fatigue and sleep disturbance and lower levels of cognitive function.ConclusionsThis study provides new knowledge regarding EI profiles among women in the year following breast cancer surgery. The non-modifiable risk factors (e.g., younger age, being non-White, having more advanced stage disease) can inform current screening procedures. The potentially modifiable risk factors can be used to develop interventions to improve employment outcomes of breast cancer patients.

Highlights

  • In 2020, over 270,000 new cases of female breast cancer were diagnosed in the United States [1]

  • Patients completed the enrollment questionnaires an average of 4 days prior to surgery and at one, two, three, four, five, six, eight, 10, and 12 months after surgery

  • We retained the within-person correlation among the self-reported employment interference (EI) scores, while we focused on the patterns of means that distinguished among the latent classes

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Summary

Introduction

In 2020, over 270,000 new cases of female breast cancer were diagnosed in the United States [1]. For women who returned to work, diminished performance was associated with pain [8], anxiety [9,10,11,12,13], fatigue [9,10,11,12,13], depression [9,10,11,12,13], and cognitive dysfunction [10, 13, 14] These limitations affected productivity, duration of the work day, and/or changes in work roles and responsibilities [5]

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