Abstract P6-05-01: Employment status patterns in a cohort of young women with breast cancer in Mexico
Authors: Villarreal-Garza Cynthia , Ferrigno Ana , Enriquez Luis F. , Fonseca Alan , Platas Alejandra , Cruz-Ramos Marlid , Miaja Melina , Vaca-Cartagena Bryan , Becerril-Gaitan Andrea , Mesa-Chavez Fernanda , Bargallo-Rocha Enrique , Mohar Alejandro 
Published: March 2023

Abstract
Background: Breast cancer diagnosis and treatment carries a disruption in multiple aspects in the life of women. For young women affected by this condition, the evidence of employment status and its change is limited. This study aims to document the first change in employment that may be experienced by young women with breast cancer and determine which factors could influence such patterns. Methods: Mexican women from the Joven & Fuerte prospective multicenter cohort, aged ≤40, diagnosed with stage I-III breast cancer between 2015-2021 with at least 6 months of follow-up were included. Participants with a documented recurrence, missing employment status information, diagnosis of a new primary breast cancer or a second type of cancer were excluded from the analysis. Patients completed surveys at baseline, 6 months, and yearly for up to 5 years to assess sociodemographic characteristics, employment status, medical and treatment data. Women were categorized on a scale of employment status as follows: full-time &gt; part-time &gt; student &gt; medical leave &gt; unemployed. Subsequently, an increase or reduction in employment status was considered whenever a participant moved up or down a category, respectively. Only the first employment status change was analyzed. The Kaplan-Meier failure estimate was employed to calculate the increase or decrease in employment status at 1 year and 2 years post-diagnosis. Competing risk regression models were undertaken to explore variables associated with a decrease in employment status. Results: A total of 142 women with a median age at diagnosis of 36.5 years (IQR 33-39) and median follow-up of 17 months were included in the analysis. Baseline employment status for these patients was: employed - full time (27%), employed - part time (14%), student (1%), medical leave (4%) and unemployed (54%). At 12 months, 18.5% of participants had a reduction in their work activities (95% CI 12.8 - 26.4%) and this proportion further increased to 25.8% at 24 months (95% CI 18.7 - 34.8%). In contrast, 11.8% (95% CI 7.3 - 19.0%) and 23.2% (95% CI 15.9 - 33.2%) of participants exhibited an increase in their work activity at 12 and 24 months, respectively. The most common patterns in first employment status change were from unemployed to employed - full time (19%), employed - full time to employed - part time (13%) and employed - full time to unemployed (13%). Age, education, monthly income, number of people who contribute to the household, number of children, being financially responsible for another person, mastectomy, chemotherapy, radiotherapy and endocrine treatment were not associated with an increase or reduction in work activity. Postmenopausal status at 1 year postdiagnosis was associated with a higher hazard for experiencing a reduction in work activity (SHR=3.05, 95% CI 1.38 - 6.72, p=0.006). Conclusion: The results from the present study appear to be in line with those of a European cohort. Further studies are needed to identify other potential factors that influence employment status trajectories. The development of interventions that tackle actionable characteristics of young patients with breast cancer at risk of employment disruption is imperative.
Citation Format: Cynthia Villarreal-Garza, Ana Ferrigno, Luis F. Enriquez, Alan Fonseca, Alejandra Platas, Marlid Cruz-Ramos, Melina Miaja, Bryan Vaca-Cartagena, Andrea Becerril-Gaitan, Fernanda Mesa-Chavez, Enrique Bargallo-Rocha, Alejandro Mohar. Employment status patterns in a cohort of young women with breast cancer in Mexico [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P6-05-01.