Sara P Myers, Yue Zheng, Kate Dibble, Elizabeth A Mittendorf, et al. JAMA Netw Open. 2024 Nov 4;7(11):e2446091
Young adults aged 18 to 39 years represent the minority of breast cancer diagnoses but are particularly vulnerable to financial hardship. A total 1008 patients were included (median age at diagnosis, 36 years). Patients' tumors were primarily stage I-II (778), estrogen receptor/progesterone receptor-positive (754), and ERBB2-negative (686). Patients were more frequently treated with mastectomy than breast conservation (771 vs 297; P < .001).Three distinct trajectories of experiences with finances emerged: 551 patients (54.7%) had low financial difficulty (trajectory 1), 293 (29.1%) had mild difficulty that improved (trajectory 2), and 164 (16.3%) had moderate to severe difficulty peaking several years after diagnosis before improving (trajectory 3). Hispanic ethnicity (OR, 3.71), unemployment at baseline and 1 year (OR, 2.66), and arm symptoms (OR, 1.77) were associated with increased odds of experiencing trajectory 3. Having a college degree (OR, 0.20) or being partnered (OR, 0.24) were associated with increased odds of experiencing trajectory 1. In this cohort study of young adults with breast cancer, we identified a subset of patients who experienced a high degree of financial difficulty persisting into early survivorship. Targeted interventions to mitigate financial toxicity-modifiable factors that include support for the employability or return to work support for those experiencing arm symptoms after treatment-are needed.
13 May, 2026