What Really Matters for Returning to Work After Breast Cancer? A 6-month Longitudinal Study and a Multidimensional Approach

Abstract

Purpose. Return to work (RTW) after breast cancer (BC) may easily impact on women recovery and quality of life. Literature on RTW hightlighed several factors associated to RTW after BC, and there is still some concern for exploring the main sociodemographic, clinical, psychological and work-related predictors of RTW after BC treatments especially when considering the first 6 months. The present study aims to explore which baseline factors are associated with RTW at 6-month after BC surgery. Methods. A 6-month follow-up study was performed among patients recruited from a Hospital in Northern Italy after their cancer-related surgery. Partecipants filled in a battery of questionnaires at baseline and at 6-month follow-up. Measurements were on job stress, work engagement, quality of life, anxiety, depression and resilience. Moreover, sociodemographic, clinical and work-related data were collected. Univariate and multivariate analyses were performed. Results. We recruited a sample of 149 patients, whose 73.9% returned to work after surgery. The women who returned to work were more likely to be not in a relationship, nor to have children. Also, they were not treated by chemiotherapy, and had higher scores in expectations of job changes after illness, RTW expectations, perception of physical quality of life and psychological resilience. In the multivariate model, chemiotherapy and women’s RTW expectations resulted as significant predictors of RTW at 6-month after BC surgery. Conclusion Most patients returned to work within first 6 months from breast surgery. Return to work was influenced by chemiotherapy and RTW expectations at baseline. A carefully individual screening of risk factors at baseline can prevent from occupational disability and long sickness absence.

Assessment of late treatment-related symptoms using patient-reported outcomes and various factors affecting return to work in survivors of breast cancer

“…Multiple factors are associated with the probability of RTW. Many studies [ 11 , 12 ] have reported that younger age, higher education level, single status, high income and good employer support are associated with higher levels of RTW. On the other hand, old age, low education level, low income and poor support were barriers to RTW.…”

“…Studies also reveal a significant association of physical, cognitive and psychological symptoms with impaired RTW and reduced level of work in a significant proportion of survivors of breast cancer [ 14 ]. Various studies [ 9 , 12 , 15 , 16 ] showed that women involved in physical work had decreased rates of RTW and difficulties adjusting to their work compared to non-manual workers. A systematic review of 26 studies [ 16 ] reported that sociodemographic factors like education and ethnicity, treatment-related factors such as side effects of chemotherapy, work-related factors like heavy physical work and disease-related factors like depression and emotional distress act as barriers to RTW in breast cancer survivors.…”