Return to work after breast cancer: The role of treatment‐related side effects and potential impact on quality of life

Abstract

For breast cancer survivors return to work (RTW) is important from an economic, societal and personal perspective. Thus, we investigated the impact of side effects and other factors on RTW. Five years post‐diagnosis 135 disease‐free breast cancer survivors below retirement age who were employed pre‐diagnosis recorded their current and previous working status and reasons for impaired RTW. Patient‐reported outcomes were prospectively reported over the cancer continuum. One year post‐surgery 57% of survivors worked the same and 22% with reduced working time compared to pre‐diagnosis. Logistic regression revealed significant associations of depressive symptoms, arm morbidity, lower education and younger age with impaired RTW after 1 year, and persisting physical fatigue and living with partner with impaired RTW after 5 years. Major self‐reported reasons included fatigue and cognitive problems. Temporal patterns of general quality of life (QoL), physical, cognitive and role function, and financial problems were significantly worse among women with no RTW compared to those working again. In conclusion, cessation of work after breast cancer seems associated with worse QoL. Fatigue, psychological and cognitive problems as well as arm morbidity seemed to hinder RTW. Thus, a better management of these problems might help women to stay in working life.

Long-Term Fatigue and Cognitive Disorders in Breast Cancer Survivors

“…An example of such negative impact is the ability of return to work after cancer treatment. Indeed, five years post-diagnosis, in addition to fatigue and psychological problems, cognitive disorders are related with difficulties in returning to work in breast cancer survivors [81]. Furthermore, cognitive complaints were shown to be associated with poorer work ability, work performance, and work productivity [82].…”

How Breast Cancer Treatments Affect the Quality of Life of Women with Non-metastatic Breast Cancer One Year After Surgical Treatment: A Cross-sectional Study in Greece.

“…Our results strengthen ndings from previous studies that also report signi cant problems including fatigue, pain in the joints and sleeping disturbances. [30,12] Patients living in a rural areas faced more nancial di culties, compared to women in urban cities and the AMA. Economic di culties are negatively correlated with QoL and as the functional status of the BC women impairs, more adverse economic situations appear.…”

“…[11] Also, survivors that are functionally deteriorated are more likely to experience adverse economic situations, such as changes in earnings, delayed work return, and problems with insurance coverage. [12] Undoubtedly, in BC treatment, the patients' survival is the clinicians' rst and most important goal. However, the disease and its treatments have some side effects that affect negatively BC survivors' life; the patient's QoL, which is often overlooked, is impaired.…”

Predictors of resignation and sick leave after cancer diagnosis among Japanese breast cancer survivors

“…While return to work (RTW) after cancer diagnosis is undoubtedly challenging due to a variety of factors, not least of which may be trying di cult physical symptoms (e.g., cancer-related fatigue, pain, hair loss, nausea, etc.) [14], however, unemployment (not working) after breast cancer diagnosis has also been shown to reduce QOL [2][3][4] and previous studies report that BCSs are more likely to be unemployed [15,16]. Contributing to this, breast cancer has shown to be associated with long RTW times, as well as a lower cumulative RTW rate compared to individuals with gastric or female genital cancer [17].…”

“…Both 5-year survival rates, as well as the number of breast cancer survivors (BCSs), continue to steadily rise in Japan due to advances in treatment and early detection [1]. As breast cancer survival rates increased, more attention has turned to issues surrounding BCSs' quality of life (QOL), including palliative care, mental health, and employment [2][3][4][5]. In 2015, approximately 55.5% of the 83,959 breast cancer survivors (BCSs) were of working age, typically de ned as 20-64 years old in Japan [6].…”