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Return to Work After Early-stage Breast Cancer: A Cohort Study into the Effects of Treatment and Cancer-related Symptoms

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Abstract

Introduction Earlier diagnosis and better treatment have increased the survival rates of cancer patients. This warrants research on return to work of cancer survivors. What is the return to work rate following early-stage breast cancer? What is the effect of the type of treatment and cancer-related symptoms on return to work? Methods Our occupational health department registers sickness absence of about 50,000 employees. In the period 2001–2005 we counted 154 cases of newly diagnosed breast cancer of which 72 were eligible for analysis. In these women, return to work was followed for 24 months after diagnosis and linked to the type of treatment and cancer-related symptoms. Results The mean duration of absence with early-stage breast cancer was 11.4 ± 5.5 months; 35% of patients were absent longer than one year and 4 patients did not return to work within two years after diagnosis. The duration of absence depended on the type of treatment and was significantly longer in patients who underwent chemotherapy (hazard rate [HR] = 0.31; 95% confidence interval [CI] = 0.12–0.81) or multimodal treatment (HR = 0.24; 95% CI = 0.10–0.54). Women started working about 4 months after the end of therapy irrespective of the type of treatment. At that moment, reaching above shoulder level was impaired in 11 patients (15%) which significantly delayed partial return to work (HR = 0.48; 95% CI = 0.23–0.98) but not full return to work (HR = 0.63; 95% CI = 0.31–1.26). Fatigue was reported by 9 patients (13%) and neither postponed partial return to work nor full return to work. Conclusions The time taken to return to work after early-stage breast cancer was principally determined by the type of treatment.

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References

  1. Bradley CJ, Bednarek HL, Neumark D. Breast cancer and women’s labor supply. Health Serv Res. 2002;37:1309–28.

    Article  PubMed  Google Scholar 

  2. Bloom JR, Stewart SL, Chang S, Banks PJ. Then and now: quality of life of young breast cancer survivors. Psychooncology. 2004;13:147–60.

    Article  PubMed  Google Scholar 

  3. 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 

  4. Van der Wouden J, Greaves-Otte J, Greaves J, Kruyt P, Van Leeuwen O, Van der Does E. Occupational reintegration of long-term cancer survivors. J Occup Med. 1992;34:1084–9.

    Article  PubMed  Google Scholar 

  5. Kagawa-Singer M. Redefining health: living with cancer. Soc Sci Med. 1993;37:295–304.

    Article  PubMed  CAS  Google Scholar 

  6. Farley Short P, Vasey J, Tunceli K. Employment pathways in a large cohort of adult cancer survivors. Cancer. 2005;103:1292–301.

    Article  Google Scholar 

  7. Bradley C, 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 

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

    Article  Google Scholar 

  9. Maunsell E, Brisson C, Dubois L, Lauzier S, Fraser A. Work problems after breast cancer: an exploratory qualitative study. Psychooncology. 1999;8:467–73.

    Article  PubMed  CAS  Google Scholar 

  10. Amir Z, Moran T, Walsh L, Iddenden R, Luker K. Return to paid work after cancer: A British experience. J Cancer Surviv. 2007;1:129–36.

    Article  PubMed  Google Scholar 

  11. Nachreiner NM, Dagher RK, McGovern PM, Baker BA, Alexander BH. Gerberich SG Successful return to work for cancer survivors. AAOHN J. 2007;55:290–5.

    PubMed  Google Scholar 

  12. Pryce J, Munir F, Haslam C. Cancer survivorship and work: symptoms, supervisor response, co-worker disclosure and work adjustment. J Occup Rehabil. 2007;17:83–92.

    Article  PubMed  Google Scholar 

  13. Janz NK, Mujahid M, Chung LK, Lantz PM, Hawley ST, Morrow M, et al. Symptom experience and quality of life of women following breast cancer treatment. J Womens Health. 2007;16:1348–61.

    Article  Google Scholar 

  14. Sakorafas GH, Peros G. Cataliotti L Sequelae following axillary lymph node dissection for breast cancer. Expert Rev Anticancer Ther. 2006;6:1629–38.

    Article  PubMed  Google Scholar 

  15. Sakorafas GH, Peros G, Cataliotti L, Vlastos G. Lymfedema following axillary lymph node dissection for breast cancer. Surg Oncol. 2006;15:153–65.

    Article  PubMed  Google Scholar 

  16. Bower JE, Ganz PA, Desmond KA, Rowland JH, Meyerowitz BE, Berlin TR. Fatigue in breast cancer survivors: occurrence, correlates, and impact on quality of life. Clin Oncol. 2000;18:743–53.

    CAS  Google Scholar 

  17. Arndt V, Stegmaier C, Ziegler H, Brenner H. A population-based study of the impact of specific symptoms on the quality of life in women with breast cancer 1 year after diagnosis. Cancer. 2006;107:2496–503.

    Article  PubMed  Google Scholar 

  18. Meeske K, Smith AW, Alfano CM, McGregor BA, McTiernan A, Baumgartner KB, et al. Fatigue in breast cancer survivors two to five years post diagnosis: a HEAL Study report. Qual Life Res. 2007;16:947–60.

    Article  PubMed  Google Scholar 

  19. Spelten ER, Verbeek JAHM, Uitterhoeve ALJ, Ansink AC, van der Lelie J, de Rijke TM, et al. Cancer, fatigue and the return of patients to work–a prospective cohort study. Eur J Cancer. 2003;39:1562–7.

    Article  PubMed  CAS  Google Scholar 

  20. Drolet M, Maunsell E, Mondor M, Brisson C, Brisson J, Masse B, et al. Work absence after breast cancer diagnosis: a population-based study. CMAJ. 2005;173:765–71.

    PubMed  Google Scholar 

  21. Drolet M, Maunsell E, Brisson J, Brisson C, Mâsse B, Dechênes 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 

  22. De Jong N, Courtens AM, Abu-Saad HH, Schouten HC. Fatigue in patients with breast cancer receiving adjuvant chemotherapy: a review of literature. Cancer Nurs. 2002;25:283–97.

    Article  PubMed  Google Scholar 

  23. De Jong N, Candel MJ, Schouten HC, Abu-Saad HH, Courtens AM. Prevalence and cause of fatigue in breast cancer patients receiving adjuvant chemotherapy. Ann Oncol. 2004;15:896–905.

    Article  PubMed  Google Scholar 

  24. Servaes P, Gielissen MF, Verhagen S, Bleijenberg G. The course of severe fatigue in disease-free breast cancer patients: a longitudinal study. Psychooncology. 2007;16:787–95.

    Article  PubMed  CAS  Google Scholar 

  25. Hayes S, Battistutta D, Newman B. Objective and subjective upper body function six months following diagnosis of breast cancer. Breast Cancer Rest Treat. 2005;94:1–10.

    Article  Google Scholar 

  26. Hayes S, Battistutta D, Parker AW, Hirst C, Newman B. Assessing task “burden” of daily activities requiring upper body function among women following breast cancer treatment. Support Care Cancer. 2005;13:255–65.

    Article  PubMed  Google Scholar 

  27. Rietman JS, Geertzen JH, Hoekstra HJ, Baas P, Dolsma WV, de Vries J, et al. Long term treatment related upper limb morbidity and quality of life after sentinel lymph node biopsy for stage I or II breast cancer. Eur J Surg Oncol. 2006;32:148–52.

    Article  PubMed  CAS  Google Scholar 

  28. Rietman JS, Dijkstra PU, Debreczeni R, Geertzen JH, Robinson DP, de Vries J. Impairments, disabilities and health related quality of life after treatment for breast cancer: a follow-up study 2.7 years after surgery. Disabil Rehabil. 2004;26:78–84.

    Google Scholar 

  29. Dutch Study Group for the Treatment of Breast Cancer. Treatment of breast cancer treatment, Alphen aan den Rijn: Van Zuiden Communications B.V.; 2005 [in Dutch].

  30. Armer JM, Radina ME, Porock D, Culbertson MD. Predicting breast-cancer related lymphedema using self-reported symptoms. Nurs Res. 2003;52:370–9.

    Article  PubMed  Google Scholar 

  31. Verbeek J, Spelten E, Kammeijer M, Sprangers M. Return to work of cancer survivors: a prospective cohort study into the quality of rehabilitation by occupational physicians. Occup Environ Med. 2003;60:352–7.

    Article  PubMed  CAS  Google Scholar 

  32. Nieuwenhuijsen K, Bos-Ransdorp B, Uitterhoeve LL, Sprangers MA, Verbeek JH. Enhanced provider communication and patient education regarding return to work in cancer survivors following curative treatment: a pilot study. J Occup Rehabil. 2006;16:647–57.

    Article  PubMed  Google Scholar 

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Acknowledgements

The authors wish to thank Prof. Dr. H. J. Hoekstra, of the department of Surgical Oncology of the University Medical Center Groningen, University of Groningen (The Netherlands) for his comments and information about the topical treatment of breast cancer.

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Authors and Affiliations

  1. ArboNed Occupational Health Services, P.O. Box 158, 8000 AD, Zwolle, Utrecht, The Netherlands

    Fulya Balak, Corné A. M. Roelen, Petra C. Koopmans & Elike E. ten Berge

  2. Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

    Corné A. M. Roelen, Petra C. Koopmans & Johan W. Groothoff

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  1. Fulya Balak
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  2. Corné A. M. Roelen
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  3. Petra C. Koopmans
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  5. Johan W. Groothoff
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Correspondence to Corné A. M. Roelen.

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Balak, F., Roelen, C.A.M., Koopmans, P.C. et al. Return to Work After Early-stage Breast Cancer: A Cohort Study into the Effects of Treatment and Cancer-related Symptoms. J Occup Rehabil 18, 267–272 (2008). https://doi.org/10.1007/s10926-008-9146-z

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  • DOI: https://doi.org/10.1007/s10926-008-9146-z

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