Skip to main content

Advertisement

Log in

Three-Year Prospective Cohort Study of Factors Associated with Return to Work After Breast Cancer Diagnosis

  • Published:
Journal of Occupational Rehabilitation Aims and scope Submit manuscript

Abstract

Purpose The purpose of this prospective cohort study of breast cancer survivors was to identify factors before diagnosis, during treatment, and after treatment that are associated with return to work (RTW). Methods A total of 288 women with breast cancer (stage I–III) and whose age were 18–65 years-old answered questionnaires at 4–6, 12, 24, and 36 months after diagnosis. The surveys asked about performance of regular exercise and health-related quality of life issues. “RTW at 36 months” was assigned to patients who reported any of the following: working at least twice; no job at baseline but working more than once; job at baseline, stopped working, and then started working again; and working during all 3 years. Results We classified 107 of 288 of the women (37.1%) as having returned to work. Analysis of pre-diagnostic factors indicated that more education and practice of regular endurance exercise were positively associated with RTW. Analysis of factors during treatment indicated that appetite loss and fatigue were negatively associated with RTW. Analysis of factors at post-treatment indicated that better body image, better physical function, better existential well-being, and participation in regular endurance and resistance exercise were positively associated with RTW. Childbirth at 12–24 months was negatively associated with RTW. Conclusion Women who participate in exercise before, during, and after treatment for breast cancer are more likely to RTW. A woman’s need to care for children, perceived body image, and existential well-being may also affect her RTW.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Siegel R, Naishadham D, Jemal A. Cancer statistics, 2012. CA Cancer J Clin. 2012;62:10–29.

    Article  PubMed  Google Scholar 

  2. Steiner JF, Cavender TA, Main DS, Bradley CJ. Assessing the impact of cancer on work outcomes. Cancer. 2004;101:1703–11.

    Article  PubMed  Google Scholar 

  3. Mehnert A. Employment and work-related issues in cancer survivors. Crit Rev Oncol Hematol. 2011;77:109–30.

    Article  PubMed  Google Scholar 

  4. Spelten ER, Sprangers MAG, Verbeek JHAM. Factors reported to influence the return to work of cancer survivors: a literature review. Psychooncology. 2002;11:124–31.

    Article  PubMed  Google Scholar 

  5. Bradley CJ, Oberst K, Schenk M. Absenteeism from work: the experience of employed breast and prostate cancer patients in the months following diagnosis. Psychooncology. 2006;15:739–47.

    Article  PubMed  Google Scholar 

  6. Mols F, Thong MSY, Vreugdenhil G, van de Poll-Franse LV. Long-term cancer survivors experience work changes after diagnosis: results of a population-based study. Psychooncology. 2009;18:1252–60.

    Article  PubMed  Google Scholar 

  7. Lee MK, Yun YH. Working situation of cancer survivors versus the general population. J Cancer Surviv. 2015;9:349–60.

    Article  PubMed  Google Scholar 

  8. Amir Z, Brocky J. Cancer survivorship and employment: epidemiology. Occup Med. 2009;59:373–7.

    Article  CAS  Google Scholar 

  9. de Boer AG, Taskila TK, Tamminga SJ, Feuerstein M, Frings-Dresen MH, Verbeek JH. Interventions to enhance return-to-work for cancer patients. Cochrane Database Syst Rev. 2015;9:CD007569.

    Google Scholar 

  10. Carlsen K, Jensen AJ, Rugulies R, Christensen J, Bidstrup PE, Johansen C, et al. Self-reported work ability in long-term breast cancer survivors. A population-based questionnaire study in Denmark. Acta Oncol. 2013;52:423–9.

    Article  PubMed  Google Scholar 

  11. Ahn E, Cho J, Shin DW, Park BW, Ahn SH, Noh DY, et al. Impact of breast cancer diagnosis and treatment on work-related life and factors affecting them. Breast Cancer Res Treat. 2009;116:609–16.

    Article  PubMed  Google Scholar 

  12. Balak F, Roelen CA, Koopmans PC, Ten Berge EE, Groothoff JW. Return to work after early-stage breast cancer: a cohort study into the effects of treatment and cancer-related symptoms. J Occup Rehabil. 2008;18:267–72.

    Article  PubMed  Google Scholar 

  13. Johnsson A, Fornander T, Rutqvist LE, Vaez M, Alexanderson K, Olsson M. Predictors of return to work ten months after primary breast cancer surgery. Acta Oncol. 2009;48:93–8.

    Article  PubMed  Google Scholar 

  14. Blinder VS, Patil S, Thind A, Diamant A, Hudis CA, Basch E, et al. Return to work in low-income Latina and non-Latina white breast cancer survivors: a 3-year longitudinal study. Cancer. 2012;118:1664–74.

    Article  PubMed  Google Scholar 

  15. Roelen CA, Koopmans PC, van Rhenen W, Groothoff JW, van der Klink JJ, Bultmann U. Trends in return to work of breast cancer survivors. Breast Cancer Res Treat. 2011;128:237–42.

    Article  CAS  PubMed  Google Scholar 

  16. Fantoni SQ, Peugniez C, Duhamel A, Skrzypczak J, Frimat P, Leroyer A. Factors related to return to work by women with breast cancer in northern France. J Occup Rehabil. 2010;20:49–58.

    Article  PubMed  Google Scholar 

  17. Bouknight RR, Bradley CJ, Luo Z. Correlates of return to work for breast cancer survivors. J Clin Oncol. 2006;24:345–53.

    Article  PubMed  Google Scholar 

  18. Drolet M, Maunsell E, Brisson J, Brisson C, Masse B, Deschenes L. Not working 3 years after breast cancer: predictors in a population-based study. J Clin Oncol. 2005;23:8305–12.

    Article  PubMed  Google Scholar 

  19. Svestkova O. International classification of functioning, disability and health of World Health Organization (ICF). Prague Med Rep. 2008;109:268–74.

    CAS  PubMed  Google Scholar 

  20. Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst. 1993;85:365–76.

    Article  CAS  PubMed  Google Scholar 

  21. Sprangers MA, Groenvold M, Arraras JI, Franklin J, te Velde A, Muller M, et al. The European Organization for Research and Treatment of Cancer breast cancer-specific quality-of-life questionnaire module: first results from a three-country field study. J Clin Oncol. 1996;14:2756–68.

    Article  CAS  PubMed  Google Scholar 

  22. Yun YH, Bae SH, Kang IO, Shin KH, Lee R, Kwon SI, et al. Cross-cultural application of the Korean version of the European Organization for Research and Treatment of Cancer (EORTC) Breast-Cancer-Specific Quality of Life Questionnaire (EORTC QLQ-BR23). Support Care Cancer. 2004;12:441–5.

    Article  PubMed  Google Scholar 

  23. Yun YH, Park YS, Lee ES, Bang SM, Heo DS, Park SY, et al. Validation of the Korean version of the EORTC QLQ-C30. Qual Life Res. 2004;13:863–8.

    Article  CAS  PubMed  Google Scholar 

  24. Mendoza TR, Wang XS, Cleeland CS, Morrissey M, Johnson BA, Wendt JK, et al. The rapid assessment of fatigue severity in cancer patients: use of the Brief Fatigue Inventory. Cancer. 1999;85:1186–96.

    Article  CAS  PubMed  Google Scholar 

  25. Yun YH, Wang XS, Lee JS, Roh JW, Lee CG, Lee WS, et al. Validation study of the Korean version of the brief fatigue inventory. J Pain Symptom Manag. 2005;29:165–72.

    Article  Google Scholar 

  26. Cohen SR, Mount BM, Tomas JJ, Mount LF. Existential well-being is an important determinant of quality of life. Evidence from the McGill Quality of Life Questionnaire. Cancer. 1996;77:576–86.

    Article  CAS  PubMed  Google Scholar 

  27. Bentur N, Resnizky S. Validation of the McGill Quality of Life Questionnaire in home hospice settings in Israel. Palliat Med. 2005;19:538–44.

    Article  PubMed  Google Scholar 

  28. Yun YH, Kim SH, Lee KM, Park SM, Kim YM. Age, sex, and comorbidities were considered in comparing reference data for health-related quality of life in the general and cancer populations. J Clin Epidemiol. 2007;60:1164–75.

    Article  PubMed  Google Scholar 

  29. Kim SH, Gu SK, Yun YH, Lee CG, Choi YS, Lee WS, et al. Validation study of the Korean version of the McGill Quality of Life Questionnaire. Palliat Med. 2007;21:441–7.

    Article  PubMed  Google Scholar 

  30. Fantoni SQ, Peugniez C, Duhamel A, Skrzypczak J, Frimat P, Leroyer A. Factors related to return to work by women with breast cancer in northern France. J Occup Rehabil. 2009;20:49–58.

    Article  Google Scholar 

  31. Hauglann BK, Saltyte Benth J, Fossa SD, Tveit KM, Dahl AA. A controlled cohort study of sickness absence and disability pension in colorectal cancer survivors. Acta Oncol. 2014;53:735–43.

    Article  PubMed  Google Scholar 

  32. Torp S, Gudbergsson SB, Dahl AA, Fossa SD, Flotten T. Social support at work and work changes among cancer survivors in Norway. Scand J Public Health. 2011;39(6 Suppl):33–42.

    Article  PubMed  Google Scholar 

  33. Groeneveld IF, de Boer AG, Frings-Dresen MH. Physical exercise and return to work: cancer survivors’ experiences. J Cancer Surviv. 2013;7:237–46.

    Article  PubMed  Google Scholar 

  34. Maguire P, Brooke M, Tait A, Thomas C, Sellwood R. The effect of counselling on physical disability and social recovery after mastectomy. Clin Oncol. 1983;9:319–24.

    CAS  PubMed  Google Scholar 

  35. Schmitz KH, Courneya KS, Matthews C, Demark-Wahnefried W, Galvao DA, Pinto BM, et al. American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc. 2010;42:1409–26.

    Article  PubMed  Google Scholar 

  36. Speck RM, Courneya KS, Masse LC, Duval S, Schmitz KH. An update of controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv. 2010;4:87–100.

    Article  PubMed  Google Scholar 

  37. van den Brink M, van den Hout WB, Kievit J, Marijnen CA, Putter H, van de Velde CJ, et al. The impact of diagnosis and treatment of rectal cancer on paid and unpaid labor. Dis Colon Rectum. 2005;48:1875–82.

    Article  PubMed  Google Scholar 

  38. Eaker S, Wigertz A, Lambert PC, Bergkvist L, Ahlgren J, Lambe M, et al. Breast cancer, sickness absence, income and marital status. A study on life situation 1 year prior diagnosis compared to 3 and 5 years after diagnosis. PLoS ONE. 2011;6:e18040.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Taskila T, Lindbohm ML. Factors affecting cancer survivors’ employment and work ability. Acta Oncol. 2007;46:446–51.

    Article  CAS  PubMed  Google Scholar 

  40. Kushi LH, Doyle C, McCullough M, Rock CL, Demark-Wahnefried W, Bandera EV, et al. American Cancer Society Guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity. CA Cancer J Clin. 2012;62:30–67.

    Article  PubMed  Google Scholar 

  41. Poulsen MG, Khan A, Poulsen EE, Khan SR, Poulsen AA. Work engagement in cancer care: the power of co-worker and supervisor support. Eur J Oncol Nurs. 2016;21:134–8.

    Article  PubMed  Google Scholar 

  42. Johnsson A, Fornander T, Rutqvist LE, Olsson M. Work status and life changes in the first year after breast cancer diagnosis. Work. 2011;38:337–46.

    PubMed  Google Scholar 

  43. Lee MK, Lee KM, Bae JM, Kim S, Kim YW, Ryu KW, et al. Employment status and work-related difficulties in stomach cancer survivors compared with the general population. Br J Cancer. 2008;98:708–15.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Bradley CJ, Neumark D, Bednarek HL, Schenk M. Short-term effects of breast cancer on labor market attachment: results from a longitudinal study. J Health Econ. 2005;24:137–60.

    Article  PubMed  Google Scholar 

  45. Thomas-MacLean R. Memories of treatment: the immediacy of breast cancer. Qual Health Res. 2004;14:628–43.

    Article  PubMed  Google Scholar 

  46. Mackenzie CR. ‘It is hard for mums to put themselves first’: how mothers diagnosed with breast cancer manage the sociological boundaries between paid work, family and caring for the self. Soc Sci Med. 2014;117:96–106.

    Article  PubMed  Google Scholar 

  47. Maunsell E, Drolet M, Brisson J, Brisson C, Masse B, Deschenes L. Work situation after breast cancer: results from a population-based study. J Natl Cancer Inst. 2004;96:1813–22.

    Article  PubMed  Google Scholar 

  48. Johnsson A, Fornander T, Rutqvist LE, Olsson M. Factors influencing return to work: a narrative study of women treated for breast cancer. Eur J Cancer Care (Engl). 2010;19:317–23.

    Article  CAS  Google Scholar 

  49. Robert TE, Young JS, Kelly VA. Relationships between adult workers’ spiritual well-being and job satisfaction: a preliminary study. Couns Values. 2006;50:165–75.

    Article  Google Scholar 

  50. Cavers D, Hacking B, Erridge SE, Kendall M, Morris PG, Murray SA. Social, psychological and existential well-being in patients with glioma and their caregivers: a qualitative study. CMAJ. 2012;184:E373–82.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Sigurgeirsdottir J, Halldorsdottir S. Existential struggle and self-reported needs of patients in rehabilitation. J Adv Nurs. 2008;61:384–92.

    Article  PubMed  Google Scholar 

  52. Sharp L, Timmons A. Social welfare and legal constraints associated with work among breast and prostate cancer survivors: experiences from Ireland. J Cancer Surviv. 2011;5:382–94.

    Article  PubMed  Google Scholar 

  53. Rasmussen DM, Elverdam B. The meaning of work and working life after cancer: an interview study. Psychooncology. 2008;17:1232–8.

    Article  PubMed  Google Scholar 

  54. Hedayati E, Johnsson A, Alinaghizadeh H, Schedin A, Nyman H, Albertsson M. Cognitive, psychosocial, somatic and treatment factors predicting return to work after breast cancer treatment. Scand J Caring Sci. 2013;27:380–7.

    Article  PubMed  Google Scholar 

  55. Hauglann B, Benth JŠ, Fosså SD, Dahl AA. A cohort study of permanently reduced work ability in breast cancer patients. J Cancer Surviv. 2012;6:345–56.

    Article  PubMed  Google Scholar 

  56. Lilliehorn S, Hamberg K, Kero A, Salander P. Meaning of work and the returning process after breast cancer: a longitudinal study of 56 women. Scand J Caring Sci. 2013;27:267–74.

    Article  PubMed  Google Scholar 

  57. Islam T, Dahlui M, Majid HA, Nahar AM, Taib NAM, Su TT, et al. Factors associated with return to work of breast cancer survivors: a systematic review. BMC Public Health. 2014;14(Suppl 3):S3–8.

    Article  Google Scholar 

  58. Choi KS, Kim E-J, Lim J-H, Kim S-G, Lim MK, Park J-G, et al. Job loss and reemployment after a cancer diagnosis in Koreans—a prospective cohort study. Psychooncology. 2007;16:205–13.

    Article  PubMed  Google Scholar 

  59. Tiedtke C, de Rijk A, Donceel P, Christiaens MR, de Casterle BD. Survived but feeling vulnerable and insecure: a qualitative study of the mental preparation for RTW after breast cancer treatment. BMC Public Health. 2012;12:538.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

This research was supported by National Cancer Center Grants (04101502) and the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (2014R1A1A1006809). None of the funding entities had anything to do with any stage of the manuscript.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Eun Sook Lee.

Ethics declarations

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical Considerations

The Institutional Review Board of the National Cancer Center approved the protocol for this study. All procedures performed in this study were in accordance with the ethical standards of the Institutional Review Board and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lee, M.K., Kang, H.S., Lee, K.S. et al. Three-Year Prospective Cohort Study of Factors Associated with Return to Work After Breast Cancer Diagnosis. J Occup Rehabil 27, 547–558 (2017). https://doi.org/10.1007/s10926-016-9685-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10926-016-9685-7

Keywords

Navigation