Return to work after early-stage breast cancer: a cohort study into the effects of treatment and cancer-related symptoms

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.