Factors associated with return to work in breast cancer survivors treated at the Public Cancer Hospital in Brazil
To evaluate the impact of return to work on the quality of life of breast cancer patients and to identify factors related to nonreturn to work.
An observational, cross-sectional study was performed in breast cancer survivors who had worked before their breast cancer diagnosis. We evaluated factors related to return to work (patient perspective, disease, and work), EORTC quality of life questionnaires (general: EORTC QLQ-C30; and breast cancer-specific: EORTC QLQ-BR23), the Shoulder Pain and Disability Index (SPADI), and the Anxiety and Depression Scale (HADS). Half of the patients underwent a physical therapy examination (shoulder goniometry, hand dynamometry, and limb volume). Univariate and multivariate analysis were performed.
We included 304 patients, 163 of whom underwent physiotherapy evaluation. Approximately 54.0% (164) of the patients returned to work after treatment. The women who returned to work presented lower age, higher education levels, higher incomes, and smaller initial tumor size. The women who returned to work had higher scores related to body image and sexual function, lower scores in relation to disability and pain, and lower scores related to anxiety and depression. In the multivariate model to evaluate nonreturn to work, pretreatment variables were age, education level, and clinical staging. Sequelae related to loss of strength increased the risk of nonreturn to work.
Return to work was influenced by age, education level, previous activity types, axillary treatment, and physical sequelae related to loss of hand strength. Breast cancer treatment decreased the women’s work capacity. Return to work improved the patients’ quality of life.
KeywordsBreast neoplasms Return to work Women, working Work capacity evaluation QoL
The authors acknowledge the Research Support Center, particularly Viviane Andrade, Janaina Santos Paulista, and Larissa Cristina Ferreira, for their assistance in the data collection process.
Compliance with ethical standards
The study was approved by the Barretos Cancer Hospital Ethics Research Committee under number 1180/2016. This local Committee is in accordance with national research committee and with the 1964 Helsinki declaration and later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.
Conflict of interest
The authors declare that they have no conflict of interest.
All patients were included in the study only after providing their approval via the informed consent form.
- 2.Damkjaer LH, Deltour I, Suppli NP, Christensen J, Kroman NT, Johansen C, Dalton SO (2011) Breast cancer and early retirement: associations with disease characteristics, treatment, comorbidity, social position and participation in a six-day rehabilitation course in a register-based study in Denmark. Acta Oncol 50(2):274–281. https://doi.org/10.3109/0284186X.2010.531048 CrossRefPubMedGoogle Scholar
- 5.Instituto Nacional de Câncer José Alencar Gomes da Silva - INCA. (2018). http://www2.inca.gov.br/wps/wcm/connect/inca/portal/home. Accessed 01 Maio 2018
- 7.Michels FAS, Latorre M, Maciel MS (2012) Validação e reprodutibilidade do questionário FACT-B+ 4 de qualidade de vida específico para câncer de mama e comparação dos questionários IBCSG, EORTC-BR23 e FACT-B+ 4. Cad Saúde Colet 20(3):321–328Google Scholar
- 12.Gandini RC (2010) Câncer de mama: consequências da mastectomia na produtividade. Temas em Psicologia 18(2)Google Scholar
- 15.Noeres D, Park-Simon TW, Grabow J, Sperlich S, Koch-Giesselmann H, Jaunzeme J, Geyer S (2013) Return to work after treatment for primary breast cancer over a 6-year period: results from a prospective study comparing patients with the general population. Support Care Cancer 21(7):1901–1909. https://doi.org/10.1007/s00520-013-1739-1 CrossRefPubMedGoogle Scholar
- 23.Thielen K, Kolodziejczyk C, Andersen I, Heinesen E, Diderichsen F (2015) Cancer stage, comorbidity, and socioeconomic differences in the effect of cancer on labour market participation: a danish register-based follow-up study. PLoS One 10(6):e0128621. https://doi.org/10.1371/journal.pone.0128621 CrossRefPubMedPubMedCentralGoogle Scholar
- 24.Cocchiara RA, Sciarra I, D’Egidio V, Sestili C, Mancino M, Backhaus I, Mannocci A, De Luca A, Frusone F, Di Bella O, Di Murro F, Palmeri V, Lia L, Paradiso G, Aceti V, Libia A, Monti M, La Torre G (2018) Returning to work after breast cancer: a systematic review of reviews. Work 61(3):463–476. https://doi.org/10.3233/WOR-182810 CrossRefPubMedGoogle Scholar
- 27.Batiston AP, Santiago SM (2005) Fisioterapia e complicações físico-funcionais após tratamento cirúrgico do câncer de mama. Fisioterapia e pesquisa 12(3):30–35Google Scholar
- 28.Peressim L, Monteiro M (2012) Retorno ao trabalho de mulheres sobreviventes de câncer de mama: fators intervenientes. Universidade de Campinas, CampinasGoogle Scholar
- 30.de Souza CN, Zomkowski K, Fernandes BL, Sacomori C, de Azevedo Guimaraes AC, Sperandio FF (2019) Physical symptoms and components of labor tasks associated with upper limb disability among working breast cancer survivors. Breast Cancer:1–7. https://doi.org/10.1007/s12282-019-01004-y CrossRefGoogle Scholar
- 42.Andersen I, Kolodziejczyk C, Thielen K, Heinesen E, Diderichsen F (2015) The effect of breast cancer on personal income three years after diagnosis by cancer stage and education: a register-based cohort study among Danish females. BMC Public Health 15:50. https://doi.org/10.1186/s12889-015-1387-0 CrossRefPubMedPubMedCentralGoogle Scholar
- 44.Landeiro L, Mano M (2017) Retorno ao trabalho em pacientes com câncer de mama tratadas em um serviço oncológico do Sistema Único de Saúde (SUS). Universidade de São Paulo, São PauloGoogle Scholar
- 50.Paalman CH, van Leeuwen FE, Aaronson NK, de Boer AG, van de Poll-Franse L, Oldenburg HS, Schaapveld M (2016) Employment and social benefits up to 10 years after breast cancer diagnosis: a population-based study. Br J Cancer 114(1):81–87. https://doi.org/10.1038/bjc.2015.431 CrossRefPubMedPubMedCentralGoogle Scholar
- 52.Dorland HF, Abma FI, Van Zon SKR, Stewart RE, Amick BC, Ranchor AV, Roelen CAM, Bultmann U (2018) Fatigue and depressive symptoms improve but remain negatively related to work functioning over 18 months after return to work in cancer patients. J Cancer Surviv 12(3):371–378. https://doi.org/10.1007/s11764-018-0676-x CrossRefPubMedPubMedCentralGoogle Scholar