Impact of Breast Cancer Treatment on Employment: Results of a Multicenter Prospective Cohort Study (CANTO)
Ines Vaz Luis
(1)
,
Mayssam El Mouhebb
,
Antonio Di Meglio
(2)
,
Agnès Dumas
(3)
,
Inês Matias Luís
(4)
,
Thomas Bovagnet
(5)
,
; Mayssam
,
El Mouhebb
,
Antonio Di Meglio
(1)
,
Sandrine Pinto
(5)
,
Cécile Charles
(6)
,
Sarah Dauchy
(7)
,
Suzette Delaloge
(2)
,
Patrick Arveux
(8)
,
Charles Coutant
,
Paul Cottu
,
Anne Lesur
,
Florence Lerebours
,
Olivier Tredan
,
Laurence Vanlemmens
,
Christelle Levy
,
Jerome Lemonnier
,
Christelle Mesleard
,
Fabrice Andre
,
Gwenn Menvielle
1
PMNCO -
Prédicteurs moléculaires et nouvelles cibles en oncologie
2 IGR - Institut Gustave Roussy
3 ECEVE (U1123 / UMR_S_1123) - Epidémiologie Clinique et Evaluation Economique Appliquées aux Populations Vulnérables
4 NOVA - Universidade Nova de Lisboa = NOVA University Lisbon
5 iPLESP - Institut Pierre Louis d'Epidémiologie et de Santé Publique
6 LPPS - EA 4057 - Laboratoire de Psychopathologie et Processus de Santé
7 DISSPO - Département Interdisciplinaire de Soins de Support aux Patients en Onco-hématologie [Gustave Roussy]
8 CESP - Centre de recherche en épidémiologie et santé des populations
2 IGR - Institut Gustave Roussy
3 ECEVE (U1123 / UMR_S_1123) - Epidémiologie Clinique et Evaluation Economique Appliquées aux Populations Vulnérables
4 NOVA - Universidade Nova de Lisboa = NOVA University Lisbon
5 iPLESP - Institut Pierre Louis d'Epidémiologie et de Santé Publique
6 LPPS - EA 4057 - Laboratoire de Psychopathologie et Processus de Santé
7 DISSPO - Département Interdisciplinaire de Soins de Support aux Patients en Onco-hématologie [Gustave Roussy]
8 CESP - Centre de recherche en épidémiologie et santé des populations
Mayssam El Mouhebb
- Fonction : Auteur
Antonio Di Meglio
- Fonction : Auteur
- PersonId : 799370
- ORCID : 0000-0002-0233-3189
- IdRef : 253571901
Agnès Dumas
- Fonction : Auteur
- PersonId : 4422
- IdHAL : agnes-dumas
- ORCID : 0000-0001-7948-6952
- IdRef : 158640462
; Mayssam
- Fonction : Auteur
El Mouhebb
- Fonction : Auteur
Sandrine Pinto
- Fonction : Auteur
- PersonId : 1112728
- IdHAL : sandrine-pinto
- ORCID : 0009-0005-7576-1773
Suzette Delaloge
- Fonction : Auteur
- PersonId : 1144179
- ORCID : 0000-0003-2106-9165
- IdRef : 165172088
Charles Coutant
- Fonction : Auteur
- PersonId : 1283656
- ORCID : 0000-0003-4355-7012
- IdRef : 144492067
Paul Cottu
- Fonction : Auteur
- PersonId : 775421
- ORCID : 0000-0001-6434-3932
- IdRef : 068862288
Anne Lesur
- Fonction : Auteur
- PersonId : 1281465
- ORCID : 0000-0002-4154-865X
- IdRef : 120480433
Florence Lerebours
- Fonction : Auteur
- PersonId : 918690
- ORCID : 0009-0006-1895-4269
- IdRef : 241867398
Olivier Tredan
- Fonction : Auteur
Laurence Vanlemmens
- Fonction : Auteur
- PersonId : 1283659
- ORCID : 0000-0001-7799-1648
- IdRef : 081435460
Christelle Levy
- Fonction : Auteur
- PersonId : 1211445
- ORCID : 0000-0003-0572-5222
- IdRef : 16740301X
Jerome Lemonnier
- Fonction : Auteur
Christelle Mesleard
- Fonction : Auteur
Fabrice Andre
- Fonction : Auteur
Gwenn Menvielle
- Fonction : Auteur
- PersonId : 832613
- IdHAL : gwenn-menvielle
- ORCID : 0000-0002-3261-6366
Résumé
PURPOSE
Adverse effects of breast cancer treatment can negatively affect survivors’ work ability. Previous reports lacked detailed clinical data or health-related patient-reported outcomes (PROs) and did not prospectively assess the combined impact of treatment and related sequelae on employment.
METHODS
We used a French prospective clinical cohort of patients with stage I-III breast cancer including 1,874 women who were working and ≥ 5 years younger than legal retirement age (≤ 57 years) at breast cancer diagnosis. Our outcome was nonreturn to work (non-RTW) 2 years after diagnosis. Independent variables included treatment characteristics as well as toxicities (Common Toxicity Criteria Adverse Events [CTCAE] v4) and PROs (European Organization for Research and Treatment of Cancer [EORTC] Quality of life Questionnaires, Breast cancer module [QLQ-BR23] and Fatigue module [QLQ-FA12], Hospital Anxiety and Depression Scale) collected 1 year after diagnosis. Logistic regression models assessed correlates of non-RTW, adjusting for age, stage, comorbidities, and socioeconomic covariates.
RESULTS
Two years after diagnosis, 21% of patients had not returned to work. Odds of non-RTW were significantly increased among patients treated with combinations of chemotherapy and trastuzumab (odds ratio [OR] v chemotherapy-hormonotherapy: for chemotherapy-trastuzumab, 2.01; 95% CI, 1.18 to 3.44; for chemotherapy-trastuzumab-hormonotherapy, 1.62; 95% CI, 1.10 to 2.41). Other significant associations with non-RTW included grade ≥ 3 CTCAE toxicities (OR v no, 1.59; 95% CI, 1.15 to 2.18), arm morbidity (OR v no, 1.59; 95% CI, 1.19 to 2.13), anxiety (OR v no, 1.47; 95% CI, 1.02 to 2.11), and depression (OR v no, 2.29; 95% CI, 1.34 to 3.91).
CONCLUSION
Receipt of systemic therapy combinations including trastuzumab was associated with increased odds of non-RTW. Likelihood of unemployment was also higher among patients who reported severe physical and psychological symptoms. This comprehensive study identifies potentially vulnerable patients and warrants supportive interventional strategies to facilitate their RTW.
Format du dépôt | Fichier |
---|---|
Type de dépôt | Article dans une revue |
Titre |
en
Impact of Breast Cancer Treatment on Employment: Results of a Multicenter Prospective Cohort Study (CANTO)
|
Résumé |
en
PURPOSE
Adverse effects of breast cancer treatment can negatively affect survivors’ work ability. Previous reports lacked detailed clinical data or health-related patient-reported outcomes (PROs) and did not prospectively assess the combined impact of treatment and related sequelae on employment.
METHODS
We used a French prospective clinical cohort of patients with stage I-III breast cancer including 1,874 women who were working and ≥ 5 years younger than legal retirement age (≤ 57 years) at breast cancer diagnosis. Our outcome was nonreturn to work (non-RTW) 2 years after diagnosis. Independent variables included treatment characteristics as well as toxicities (Common Toxicity Criteria Adverse Events [CTCAE] v4) and PROs (European Organization for Research and Treatment of Cancer [EORTC] Quality of life Questionnaires, Breast cancer module [QLQ-BR23] and Fatigue module [QLQ-FA12], Hospital Anxiety and Depression Scale) collected 1 year after diagnosis. Logistic regression models assessed correlates of non-RTW, adjusting for age, stage, comorbidities, and socioeconomic covariates.
RESULTS
Two years after diagnosis, 21% of patients had not returned to work. Odds of non-RTW were significantly increased among patients treated with combinations of chemotherapy and trastuzumab (odds ratio [OR] v chemotherapy-hormonotherapy: for chemotherapy-trastuzumab, 2.01; 95% CI, 1.18 to 3.44; for chemotherapy-trastuzumab-hormonotherapy, 1.62; 95% CI, 1.10 to 2.41). Other significant associations with non-RTW included grade ≥ 3 CTCAE toxicities (OR v no, 1.59; 95% CI, 1.15 to 2.18), arm morbidity (OR v no, 1.59; 95% CI, 1.19 to 2.13), anxiety (OR v no, 1.47; 95% CI, 1.02 to 2.11), and depression (OR v no, 2.29; 95% CI, 1.34 to 3.91).
CONCLUSION
Receipt of systemic therapy combinations including trastuzumab was associated with increased odds of non-RTW. Likelihood of unemployment was also higher among patients who reported severe physical and psychological symptoms. This comprehensive study identifies potentially vulnerable patients and warrants supportive interventional strategies to facilitate their RTW.
|
Auteur(s) |
Ines Vaz Luis
1
, Mayssam El Mouhebb
, Antonio Di Meglio
2
, Agnès Dumas
3
, Inês Matias Luís
4
, Thomas Bovagnet
5
, ; Mayssam
, El Mouhebb
, Antonio Di Meglio
1
, Sandrine Pinto
5
, Cécile Charles
6
, Sarah Dauchy
7
, Suzette Delaloge
2
, Patrick Arveux
8
, Charles Coutant
, Paul Cottu
, Anne Lesur
, Florence Lerebours
, Olivier Tredan
, Laurence Vanlemmens
, Christelle Levy
, Jerome Lemonnier
, Christelle Mesleard
, Fabrice Andre
, Gwenn Menvielle
1
PMNCO -
Prédicteurs moléculaires et nouvelles cibles en oncologie
( 1042019 )
- Bâtiment de médecine moléculaire, Niveau 1, 114 rue Edouard Vaillant,
94800, Villejuif
- France
2
IGR -
Institut Gustave Roussy
( 156104 )
- 114, rue Édouard-Vaillant 94805 Villejuif Cedex -France
- France
3
ECEVE (U1123 / UMR_S_1123) -
Epidémiologie Clinique et Evaluation Economique Appliquées aux Populations Vulnérables
( 1005005 )
- 48 Boulevard Sérurier 75019 Paris
- France
4
NOVA -
Universidade Nova de Lisboa = NOVA University Lisbon
( 327246 )
- Campus de Campolide
1099-085 Lisboa
- Portugal
5
iPLESP -
Institut Pierre Louis d'Epidémiologie et de Santé Publique
( 542132 )
- 56, boulevard Vincent Auriol - CS 81393 - 75646 Paris Cedex 13
- France
6
LPPS - EA 4057 -
Laboratoire de Psychopathologie et Processus de Santé
( 412039 )
- Institut de Psychologie
Université Paris Descartes - Centre Henri Piéron
71 Avenue Edouard Vaillant
92774 Boulogne-Billancourt Cedex
- Arabie saoudite
7
DISSPO -
Département Interdisciplinaire de Soins de Support aux Patients en Onco-hématologie [Gustave Roussy]
( 456843 )
8
CESP -
Centre de recherche en épidémiologie et santé des populations
( 1051097 )
- 16 avenue Paul Vaillant Couturier 94807 Villejuif Cedex, France
- France
|
Langue du document |
Anglais
|
Nom de la revue |
|
Vulgarisation |
Non
|
Comité de lecture |
Oui
|
Audience |
Internationale
|
Date de publication |
2020-03-01
|
Volume |
38
|
Numéro |
7
|
Page/Identifiant |
734-743
|
Domaine(s) |
|
Projet(s) ANR |
|
DOI | 10.1200/jco.19.01726 |
Origine :
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