title: Employment and social benefits up to 10 years after breast cancer diagnosis: a population-based study.
abstract: BACKGROUND
  Little is known about employment outcomes after breast cancer (BC) beyond the first years after treatment.
  
  
  METHODS
  Employment outcomes were compared with a general population comparison group (N=91 593) up to 10 years after BC for 26 120 patients, diagnosed before age 55 between 2000-2005, with income and social benefits data from Statistics Netherlands. Treatment effects were studied in 14 916 patients, with information on BC recurrences and new cancer events.
  
  
  RESULTS
  BC survivors experienced higher risk of losing paid employment (Hazard Ratio (HR): 1.6, 95% Confidence Interval (95% CI) 1.4-1.8) or any work-related event up to 5-7 years (HR 1.5, 95% CI 1.3-1.6) and of receiving disability benefits up to 10 years after diagnosis (HR 2.0, 95% CI 1.6-2.5), with higher risks for younger patients. Axillary lymph node dissection increased risk of disability benefits (HR 1.5, 95% CI 1.4-1.7) or losing paid employment (HR 1.3, 95% CI 1.2-1.5) during the first 5 years of follow-up. Risk of disability benefits was increased among patients receiving mastectomy and radiotherapy (HR 1.2; 95% CI 1.1-1.3) and after chemotherapy (HR 1.7; 95% CI 1.5-1.9) during the first 5 years after diagnosis.
  
  
  CONCLUSIONS
  BC treatment at least partly explains the increased risk of adverse employment outcomes up to 10 years after BC.
authors.affiliation: Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
authors.forename: C H
authors.initials: CH
authors.lastname: Paalman
authors.affiliation: Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
authors.forename: F E
authors.initials: FE
authors.lastname: van Leeuwen
authors.affiliation: Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
authors.forename: N K
authors.initials: NK
authors.lastname: Aaronson
authors.affiliation: Coronel Institute of Occupational Health, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: A G E M
authors.initials: AG
authors.lastname: de Boer
authors.affiliation: Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.|CoRPS- Centre of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, The Netherlands.
authors.forename: L
authors.initials: L
authors.lastname: van de Poll-Franse
authors.affiliation: Department of Surgical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
authors.forename: H S A
authors.initials: HS
authors.lastname: Oldenburg
authors.affiliation: Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.|Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Schaapveld
mesh_terms: D001943:Breast Neoplasms / Q000628:therapy*; D004651:Employment; D005260:Female; D006801:Humans; D016016:Proportional Hazards Models; D012946:Social Welfare; D013997:Time Factors