Factors associated with return to work in breast cancer survivors treated at the Public Cancer Hospital in Brazil

  • Isabela Caroline Freitas Colombino
  • Almir José Sarri
  • Isabela Queiros Castro
  • Carlos Eduardo Paiva
  • René Aloisio da Costa VieiraEmail author
Original Article



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.


Breast 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.

Informed consent

All patients were included in the study only after providing their approval via the informed consent form.

Supplementary material

520_2019_5164_MOESM1_ESM.docx (68 kb)
ESM 1 (DOCX 67 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2020

Authors and Affiliations

  1. 1.Postgraduate Oncology ProgramBarretos Cancer HospitalBarretosBrazil
  2. 2.Department of PhysiotherapyBarretos Cancer HospitalBarretosBrazil
  3. 3.Nucleus of StatisticsBarretos Cancer HospitalBarretosBrazil
  4. 4.Department of Mastology and Breast ReconstructionBarretos Cancer HospitalBarretosBrazil
  5. 5.Palliative Care, QoL GroupCNPQBrasiliaBrazil
  6. 6.Postgraduate Program in Gynecology, Obstetrics and MastologyBotucatu School of Medicine, UNESPBotucatuBrazil
  7. 7.QoL Group/EORTCBrusellsBelgium

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