Background A diagnosis of cancer negatively impacts the financial wellbeing of affected individuals as well as their households. We aimed to gain an in‐depth understanding of the financial needs following diagnosis of breast cancer in a middle‐income setting with universal health coverage. Materials and Methods Twelve focus group discussions (n = 64) were conducted with women with breast cancer from two public and three private hospitals. This study specifically focused on (a) health costs, (b) nonhealth costs, (c) employment and earnings, and (d) financial assistance. Thematic analysis was used. Results Financial needs related to cancer treatment and health care varied according to the participant's socioeconomic background and type of medical insurance. Although having medical insurance alleviated cancer treatment‐related financial difficulties, limited policy coverage for cancer care and suboptimal reimbursement policies were common complaints. Nonhealth expenditures were also cited as an important source of financial distress; patients from low‐income households reported transport and parking costs as troublesome, with some struggling to afford basic necessities, whereas participants from higher‐income households mentioned hired help, special food and/or supplements and appliances as expensive needs following cancer. Needy patients had a hard time navigating through the complex system to obtain financial support. Irrespective of socioeconomic status, reductions in household income due to loss of employment and/or earnings were a major source of economic hardship. Conclusion There are many unmet financial needs following a diagnosis of (breast) cancer even in settings with universal health coverage. Health care professionals may only be able to fulfill these unmet needs through multisectoral collaborations, catalyzed by strong political will. Implications for Practice As unmet financial needs exist among patients with cancer across all socioeconomic groups, including for patients with medical insurance, financial navigation should be prioritized as an important component of cancer survivorship services, including in the low‐ and middle‐income settings. Apart from assisting survivors to understand the costs of cancer care, navigate the complex system to obtain financial assistance, or file health insurance claims, any planned patient navigation program should also provide support to deal with employment‐related challenges and navigate return to work. It is also echoed that costs for essential personal items (e.g., breast prostheses) should be covered by health insurance or subsidized by the government.

Background: Cancer survivorship as an area, which focuses on the health and life of an individual following cancer diagnosis and treatment is increasingly being recognized as an important component of the cancer control continuum. Advances in breast cancer detection and treatments have resulted in a growing number of patients experiencing a breast cancer diagnosis at an age when career plays an important role in their lives. Yet, very little is known on how breast cancer affects employment and return to work among survivors, particularly in low- and middle-income settings. Aim: This qualitative study aims to gain an in-depth understanding on employment challenges and motivators/barriers in return to work faced by breast cancer survivors in an upper-middle income Asian setting. Methods: Eleven focus group discussions (FGDs) were conducted with breast cancer survivors representing various ethnicities and socioeconomic backgrounds in Malaysia. Patients diagnosed one to two years prior to the study were recruited from a general public hospital, a public academic hospital and two private hospitals. Data from the FGDs were examined using thematic content analysis from the NVivo software. Results: The major themes relating to impact of cancer diagnosis on employment were “decreased work ability”, “job loss”, “long absenteeism” and “hostile work environment”. Coping strategy themes frequently mentioned to offset income loss from employment changes were “savings”, “part-time work” or financial support from “family/friends” or “social security”. However, participants were quick to highlight the insufficiency and unreliability of these strategies to cope financially in the long run. When describing their decision in choosing to return to work, participants mentioned themes such as “need money”, feeling “more happy” or having a “supportive work environment”. Nonetheless, participants emphasized the “discrimination” they faced in finding a job after active treatment. Specifically, participants' frequent need to take time-off from work for their cancer follow-ups as well as their older age were perceived as disadvantages in seeking employment when compared with younger, healthy applicants. Conclusion: It is evident that a breast cancer diagnosis severely disrupts employment and return to work in middle income settings. Multisectoral interventions are urgently required to improve the employment status of our cancer survivors, including legislative reforms to prevent discrimination. Programs supporting employment and return to work among cancer survivors should be developed and integrated in the provision of a holistic survivorship care.