Employment Concerns and Associated Impairments of Women Living With Advanced Breast Cancer.
Kathleen Doyle Lyons, Robin M Newman, Michael Sullivan and 3 others
PMID 33543044WHAT IT FOUND
Most women with advanced breast cancer had stopped working by the study.
Many reported reduced productivity and need for rest. Lower function and more symptoms were linked to work distress, but this cross-sectional study cannot show what causes job loss.
Key findings
0170% of the sample had worked before diagnosis, but only 21% were working at the time of the survey; 1 of the 35 working women had not worked before diagnosis.
02Among 163 women, 75% reported accomplishing less than they wanted, 71% took frequent rests, 71% cut down time spent on work or other activities, 68% were limited in the kind of work or other activities, and 44% required special assistance.
03In adjusted models, older age (odds ratio 0.93) and more chemotherapy regimens (odds ratio 0.62) were associated with lower odds of current employment, while living alone (odds ratio 4.2) was associated with higher odds; the study cannot show direction.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The data were cross-sectional, so associations cannot show cause or direction. Data were collected in 1999, and breast cancer treatment and workplaces have changed since then. Excluded women were more likely to be of Asian descent than enrolled women, 73% versus 2.5%, so the sample may not represent all women with advanced breast cancer. The study did not assess job requirements, workplace accommodations requested or granted, or cognitive function rigorously. The KPS and FIM are gross measures of function and may miss meaningful functional associations. Multiple comparisons were not controlled, so some associations may be chance findings. Only women with metastatic breast cancer, English fluency, Karnofsky scores of 40 to 90, and intact cognition were enrolled. Some subgroup analyses used fewer women, including 114, 80, and 161.
The easy way to misread this
Do not conclude that improving strength, endurance, pain, or mobility will help a woman return to work. The study measured associations at one time and did not test rehabilitation, so it cannot show that any single impairment caused job loss or that treating it would change employment.