Return to Work after Breast Cancer Surgery
| Institution: | Women's Cancer Resource Center | ||
| Investigator(s): |
Rani Eversley , Ph.D. -
Diane Estrin , BA -
|
||
| Award Cycle: | 2001 (Cycle VII) | Grant #: 7BB-1500 | Award: $625,000 |
| Award Type: | CRC Full Research Award | ||
| Research Priorities | |||
| Health Policy & Health Services>Health Policy and Health Services: better serving women's needs | |||
Initial Award Abstract (2001)
The objectives of this study are to:
- To determine the percentage of women who return to work during the eighteen months after breast cancer surgery and to compare this percentage across ethnic groups.
- To determine the percentage of women who return to pre-surgery work levels during the eighteen months following breast cancer surgery and to determine this percentage across ethnic groups.
- To describe the predictors for returning to work during the eighteen months following breast cancer surgery considering the following variables: a) race/ethnicity, b) income, c) presence of additional household support, d) dependent children/elders e) enrollment in disability benefits, f) work flexibility, g) stage of disease, h) breast cancer treatment, i) fatigue, and j) social support for returning to work (social support for returning to work will be examined with new measures developed during the BCRP funded pilot stage of our project).
- To develop and test the "Women's Work Return Process": a model to describe the relationship between the variables that predict women's return to work.
Final Report (2006)
The objective of this study was to describe the factors predicting return to work among a multi-ethnic sample of women at baseline (0-3 months) and at 6 and 12 months after breast cancer surgery. Specific AIMS include: 1) To determine the percentage of women who return to work during the twelve months after breast cancer surgery and to compare this percentage across ethnic groups, 2) To compare the percentage of women who return to pre-surgery work levels during the twelve months following breast cancer surgery and to determine this percentage across ethnic groups. 3) To describe the predictors for returning to work during the twelve months following breast cancer surgery. Three hundred and ninety-nine working women were enrolled in this study: 34% Caucasian, 29% African American, 21% Latino, 8% Asian and 3% of other ethnic backgrounds. Ninety-three percent identified as heterosexual, 5% lesbian, and 2% bisexual. The mean age of the sample was 50.6 (21-66), the mean years of education completed was 11.7 (0-20). Sixty-one percent reported a lumpectomy and 39% mastectomy. The mean income before breast cancer surgery was reported to be $1,503 ($0-$3,600), the mean income at baseline (within three months after surgery) was reported to be $1,207 (Range = $0-$3,200). At the six month follow-up, 116 respondents (29%) were interviewed. Their average number of weeks off from work was 3.87 and their average income at six months after breast cancer surgery was $1,346 (Range = $0-$3,100). Less than a third (29%) had returned to work at six months. Respondents at six months reported significant levels of symptoms. More than half had noticeable swelling (51%) or pain (51%). Fatigue was commonly reported, with 16% indicating extreme levels of fatigue. The most recent follow-up was at twelve months. Early analysis indicates only a slight increase in return to work after one year (33%). Symptoms common at 6 months persisted at the one year mark. Swelling was reported by 42% and pain by 45% of respondents. Extreme fatigue was just as prevalent at 12 months (18%). At twelve months 22% reported a relationship change and 34% told us their housing situation had changed. We anticipate that by September of 2006, we will be able to determine the quality of these changes. The mean number of weeks off from work at twelve months was 8.19. The mean income at twelve months after surgery was $1,375 (Range = $0-$3,100), still below pre-surgical levels. The data strongly suggests that ability to earn an income suffers significantly among low-income breast cancer survivors, and women may never return to their pre-surgery levels. Workplace and disability policy changes to accommodate these losses may significantly improve quality of life for this group.
Symposium Abstract (2003)
Objectives: The objective of this study is to measure factors that predict return to work among a multi-ethnic sample of 500 women subsequent to breast cancer surgery. Methods: The Avenues Cohort consists of an ethnically stratified sample of Caucasian, African American and Latina women invited to join the longitudinal study in the three months immediately following their breast cancer surgery. Each woman in the study will be interviewed at baseline and again in 6 months and 12 months. Women are enrolled from the Women’s Cancer Resource Center (WCRC), the Cancer Navigator Program at the Alameda County Medical Center, Highland Hospital Campus, and from other community sites. Data are entered and analyzed at UCSF. Results: Thus far, two hundred and sixty two baseline and 60 follow-up interviews have been completed For the first 241 participants, the mean age is 50 (21-90), the mean years of education is 11.7 (1-18), and the mean monthly income prior to breast cancer surgery is $1567 ($0-$3600). Thirty-five percent are Caucasian, 23% African American, 25% Latina, 9% Asian, and 8% women of other ethnic backgrounds. Seventy-two percent reported that they are primarily English speakers. Ninety-five percent were working at the time of their breast cancer diagnosis. At baseline, (approximately one month after diagnosis) 42% were employed full-time and 15% half-time. Forty-four percent were currently unemployed. Of those not working, 35% are on sick leave. Fifty-four percent report that their employers expect them back to work. The mean number of weeks taken off from work for breast cancer treatment was 4.2, and 46% of the women surveyed reported that this time was unpaid. Among those women who have returned to work, 40% are working fewer hours than before breast cancer surgery. Ethnic differences were found in education, income, weeks off from work, paid time off, and in level of job demands. Latinas reported significantly fewer years of education, less income, fewer weeks off from work, and were less likely to report paid time off as compared to the other ethnic groups (p<0.01). Latinas also reported more physically demanding work (lifting and stooping) as compared to the other ethnic groups (p<0.01). Conclusions: These preliminary data suggest that there are significant ethnic differences in time off that appear to reflect access to disability related income (sick leave or disability pay). The fact that Latinas return to work more quickly and face more demanding physical tasks at work, suggests they may be at increased risk for post-surgical complications such as lymphedema and fatigue that could ultimately effect their long-term ability to work.
Post-treatment symptoms among ethnic minority breast cancer survivors.
Periodical:Oncology Nursing Forum
Index Medicus: Oncol Nurs Forum
Authors: Eversley R, Estrin D, Dibble S, Wardlaw L, Pedrosa M, Favila-Penney W.
| Yr: 2005 | Vol: 32 | Nbr: 2 | Abs: | Pg:250-256 |
