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Employment trajectories of young women with breast cancer: an ongoing prospective cohort study in Italy and Switzerland

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Abstract

Purpose

Despite extensive research on cancer and work-related outcomes, evidence from longitudinal cohort studies is limited, especially in young women with breast cancer (BC). We aimed to investigate employment trajectories in young BC survivors and to identify potential factors associated with changes in work activity.

Methods

The HOHO European prospective multicenter cohort study enrolled 300 young women (≤ 40 years) with newly diagnosed BC. Women completed surveys at baseline and every 6 months for 3 years, then yearly for up to 10 years to assess, among other variables, employment status, sociodemographic, medical, and treatment data. Symptoms were assessed by the Breast Cancer Prevention Trial symptom scales and single items from the Cancer Rehabilitation Evaluation System. Univariable and multivariable multinomial logistic regression analyses identified factors associated with changes in employment status.

Results

Among the 245 women included in this analysis, 85% were employed at the last individual post-baseline assessment (1 to 10 years). At 5 years, women had a 29.4% probability (95% CI: 23.6–35.5) of experiencing any reduction and a 14.9% probability (95% CI: 10.6–19.9) of experiencing any increase in work activities. Being enrolled in Switzerland (vs. Italy) and reporting more trouble in performing daily activities were significantly associated with work reduction.

Conclusion

Our results suggest that most young BC survivors remain employed in the long-term.

Implications for Cancer Survivors

Regular evaluation of symptoms which may interfere with daily life and identification of financial discomfort is critical in providing timely and individually tailored interventions and in limiting unwanted reductions in work activities.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

The IBCSG 43-09 HOHO European protocol was developed and conducted by the Frontier Science & Technology Research Foundation, Southern Europe (FSE) and the International Breast Cancer Study Group (IBCSG) with the financial support of the Fondazione Leonardo, Lugano Switzerland, Pink Ribbon Switzerland and private donations. We thank the patients, physicians, nurses, and trial coordinators who participated in the HOHO study.

Funding

This work was supported by the Frontier Science & Technology Research Foundation, Southern Europe (FSE), Chiasso, Switzerland and the International Breast Cancer Study Group (IBCSG), Bern, Switzerland.

Author information

Authors and Affiliations

  1. Quality of Life Office, International Breast Cancer Study Group, Bern, Switzerland

    Karin Ribi

  2. Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy

    Eleonora Pagan, Isabella Sala & Vincenzo Bagnardi

  3. Program for Young Patients, International Breast Cancer Study Group, Bern, Switzerland

    Monica Ruggeri

  4. Division of Medical Senology, IEO, European Institute of Oncology IRCCS, Milan, Italy

    Nadia Bianco

  5. Breast Cancer Unit, OspedaleMultiMedica, Castellanza, VA, Italy

    Eraldo Oreste Bucci

  6. Oncology Institute of Southern Switzerland, EOC, Bellinzona, Switzerland

    Rossella Graffeo

  7. Division of Oncology (Oncocare), Klinik Engeried, Lindenhofgruppe, Bern, Switzerland

    Markus Borner

  8. ASST-Lariana, Como, Italy

    Monica Giordano

  9. Department of Medical Oncology, Ospedale Infermi, AUSL Della Romagna, Rimini, Italy

    Lorenzo Gianni

  10. Department of Medical Oncology, Bern University Hospital, University of Bern, Inselspital, Bern, Switzerland

    Manuela Rabaglio

  11. Department of Medical Oncology, CRO, Aviano, Italy

    Andrea Freschi

  12. Department of Medical Oncology, Azienda Sanitaria Dell’Alto Adige, Bolzano, Italy

    Elisabetta Cretella

  13. Department of Medical Oncology, Ospedale degli Infermi, Biella, Italy

    Elena Seles

  14. Department of Medical Oncology, IRCCS Istituto Romagnolo Per Lo Studio Dei Tumori (IRST) “Dino Amadori”, Meldola, Italy

    Alberto Farolfi

  15. Breast Unit, ASST Spedali Civili Di Brescia, Brescia, Italy

    Edda Simoncini

  16. U.O. Oncologia Medica, Vito Fazzi Hospital, Lecce, Italy

    Mariangela Ciccarese

  17. Medical Oncology, Spital STS, Thun, Switzerland

    Daniel Rauch

  18. Medical Oncology Unit, Azienda ULSS2 Marca Trevigiana, Treviso, Italy

    Adolfo Favaretto

  19. Tumor- and Breast Center ZeTuP, St. Gallen, Switzerland

    Agnes Glaus

  20. Department of Medical Oncology, Università Politecnica Delle Marche, A.O.U. Ospedali Riuniti Di Ancona, Ancona, Italy

    Rossana Berardi

  21. Radiotherapy Service, Clinica Luganese Moncucco, Lugano, Switzerland

    Alessandra Franzetti-Pellanda

  22. Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA

    Shari Gelber & Ann H. Partridge

  23. Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Ann H. Partridge

  24. International Breast Cancer Study Group, IEO European Institute of Oncology, IRCCS, Milan, Italy

    Aron Goldhirsch

  25. Swiss Group for Clinical Cancer Research (SAKK), Interdisciplinary Cancer Service Hospital Riviera-Chablais Rennaz, Vaud, Geneva University Hospitals, Lugano University, Lugano, Switzerland

    Olivia Pagani

Authors
  1. Karin Ribi
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  2. Eleonora Pagan
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  3. Isabella Sala
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  4. Monica Ruggeri
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  5. Nadia Bianco
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  6. Eraldo Oreste Bucci
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  7. Rossella Graffeo
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  8. Markus Borner
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  9. Monica Giordano
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  10. Lorenzo Gianni
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  11. Manuela Rabaglio
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  12. Andrea Freschi
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  13. Elisabetta Cretella
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  14. Elena Seles
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  15. Alberto Farolfi
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  16. Edda Simoncini
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  17. Mariangela Ciccarese
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  18. Daniel Rauch
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  19. Adolfo Favaretto
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  20. Agnes Glaus
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  21. Rossana Berardi
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  22. Alessandra Franzetti-Pellanda
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  23. Vincenzo Bagnardi
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  24. Shari Gelber
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  25. Ann H. Partridge
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  26. Aron Goldhirsch
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  27. Olivia Pagani
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Contributions

Karin Ribi PhD: manuscript writing — original draft; manuscript review, editing, and approval. Eleonora Pagan PhD: statistical analysis, manuscript writing — original draft; manuscript review, editing, and approval. Isabella Sala MSc: statistical analysis, manuscript writing — original draft; manuscript review, editing, and approval. Monica Ruggeri: conceptualization and study design; data management; manuscript writing — original draft; manuscript review, editing, and approval. Nadia Bianco MD: data acquisition; manuscript review, editing, and approval. Eraldo Oreste Bucci MD: data acquisition; manuscript review, editing, and approval. Rossella Graffeo MD: data acquisition; manuscript review, editing, and approval. Markus Borner MD: data acquisition; manuscript review, editing, and approval. Monica Giordano MD: data acquisition; manuscript review, editing, and approval. Lorenzo Gianni MD: data acquisition; manuscript review, editing, and approval. Manuela Rabaglio MD: data acquisition; manuscript review, editing, and approval. Andrea Freschi MD: data acquisition; manuscript review, editing, and approval. Elisabetta Cretella MD: data acquisition; manuscript review, editing, and approval. Elena Seles MD: data acquisition; manuscript review, editing, and approval. Alberto Farolfi MD: data acquisition; manuscript review, editing, and approval. Edda Simoncini MD: data acquisition; manuscript review, editing, and approval. Mariangela Ciccarese MD: data acquisition; manuscript review, editing, and approval. Daniel Rauch MD: data acquisition; manuscript review, editing, and approval. Adolfo Favaretto MD: data acquisition; manuscript review, editing, and approval. Agnes Glaus PhD, MSc: data acquisition; manuscript review, editing, and approval. Rossana Berardi MD: data acquisition; manuscript review, editing, and approval. Alessandra Franzetti-Pellanda MD: data acquisition; manuscript review, editing, and approval. Vincenzo Bagnardi PhD: conceptualization and study design, statistical analysis, manuscript writing — original draft; manuscript review, editing, and approval. Shari Gelber PhD, MSc: conceptualization and study design; statistical analysis; manuscript review, editing, and approval. Ann H. Partridge MD, MPH: conceptualization and study design; manuscript review, editing, and approval. Aron Goldhirsch MD: conceptualization and study design. Olivia Pagani MD: conceptualization and study design; data acquisition; manuscript writing — original draft; manuscript review, editing, and approval.

Corresponding author

Correspondence to Karin Ribi.

Ethics declarations

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Consent for publication

The manuscript does not contain any individual person’s data in any form, and consent for publication was therefore not obtained from the patients included in this study.

Competing interests

Karin Ribi reports no conflicts related to this study, Eleonora Pagan reports no conflicts related to this study, Isabella Sala reports no conflicts related to this study, Monica Ruggeri reports no conflicts related to this study, Nadia Bianco reports no conflicts related to this study, Eraldo Oreste Bucci receives consulting or advisory fees from Astra Zeneca and travels/accommodations from Astellas, BMS, Lilly, Merck Serono, Roche, Takeda, Rossella Graffeo reports no conflicts related to this study, Markus Borner reports no conflicts related to this study, Monica Giordano reports no conflicts related to this study, Lorenzo Gianni receives consulting or advisory fees from Astra Zeneca and travels/accommodations from Novartis, Manuela Rabaglio reports no conflicts related to this study, Andrea Freschi reports no conflicts related to this study, Elisabetta Cretella reports no conflicts related to this study, Elena Seles reports no conflicts related to this study, Alberto Farolfi receives honoraria from Janssen Oncology, GSK-Tesaro, Astrazeneca, Clovis, Edda Simoncini reports no conflicts related to this study, Mariangela Ciccarese reports no conflicts related to this study, Daniel Rauch (pending), Adolfo Favaretto reports no conflicts related to this study, Agnes Glaus reports no conflicts related to this study, Rossana Berardi receives donations to her institution and/or fees for advisory board participations from AZ, BI, Novartis, MSD, Otsuka, Lilly, Roche, Amgen, GSK, EISAI (none related to this study), Alessandra Franzetti-Pellanda reports no conflicts related to this study, Vincenzo Bagnardi reports no conflicts related to this study, Shari Gelber reports no conflicts related to this study, Ann H. Partridge (pending), and Olivia Pagani reports no conflicts related to this study.

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Aron Goldhirsch deceased.

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Ribi, K., Pagan, E., Sala, I. et al. Employment trajectories of young women with breast cancer: an ongoing prospective cohort study in Italy and Switzerland. J Cancer Surviv 17, 1847–1858 (2023). https://doi.org/10.1007/s11764-022-01222-y

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  • DOI: https://doi.org/10.1007/s11764-022-01222-y

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