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Review
. 2022 Dec;30(12):10301-10310.
doi: 10.1007/s00520-022-07449-w. Epub 2022 Nov 10.

The role of physical arm function and demographic disparities in breast cancer survivors' ability to return to work

Meghan E Vidt  1   2 , Jared Heitzenrater  3 , Daleela Dodge  4   5 , John Potochny  4   6 , Kristine Widders  4 , Melody Paulishak  4 , Dino Ravnic  4   6 , Cathy R Henry  4   6 , Michael Green  5   7 , Rena Kass  4   7 , Kathryn H Schmitz  8   3
Affiliations
Review

The role of physical arm function and demographic disparities in breast cancer survivors' ability to return to work

Meghan E Vidt et al. Support Care Cancer. 2022 Dec.

Abstract

Purpose: Ability to return to work (RTW) is an important aspect of breast cancer that is limited for many survivors. With 90% survivorship in the USA, it is imperative that focus shifts toward the improvement of physical arm function to improve survivors' ability to RTW. This narrative review discusses the role of physical arm function and demographic disparities in breast cancer survivor RTW.

Methods: Literature on physical function, arm function, and demographic disparities following breast cancer treatment and their implications for RTW is discussed.

Results: The ability to RTW is a key component of recovery for breast cancer survivors, but challenges and inequalities persist. Treatment effects can induce and prolong functional disability, affecting survivors' ability to RTW. These effects may be compounded for survivors whose occupation requires physical arm function. The RTW landscape, including the occupations survivors have, the physical function required for job tasks, and availability of workplace accommodations, is also unclear. Additional demographic disparities (e.g., income, live in rural area) exist, but the extent to which these factors influence RTW is not well understood. More work is needed to understand the compounded impact of treatment effects, demographic disparities, and occupational factors on RTW. Multidisciplinary rehabilitation that includes occupational counseling and exercise is a promising approach, but widespread adoption in the US healthcare model presents an ongoing challenge. Areas for further research are highlighted.

Conclusion: There is an incomplete understanding of the effects of treatment on physical arm function and the role of demographic disparities on breast cancer survivor RTW.

Keywords: Breast reconstruction; Cancer survivors; Mastectomy; Physical endurance; Return to work; Treatment outcome.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Mastectomy and breast reconstruction procedures affect the local anatomy differently. A After mastectomy, the affected breast tissue is removed, and the breast is not reconstructed. B Breast reconstruction with implants often requires dissection of the pectoralis major muscle from the chest wall to place the implant. This procedure can also include implantation of a mesh to provide inferior support to the implant. C Breast reconstruction with autologous flaps requires dissection of tissue from one body region to the breast. One example of autologous flap procedures includes the latissimus dorsi (LAT flap) procedure, where a portion of the muscle is dissected and reflected to aid in reconstruction of the breast. This procedure commonly includes the use of an implant in addition to the reflected muscle flap
Fig. 2
Fig. 2
The ability to return to work (RTW) is multifactorial and motivated by a diversity of factors, such as arm mobility and function, household finances, work accommodations and flexibility, occupational task requirements, and post-treatment resources and support. Directly addressing each of these contributing factors in the treatment pathway for breast cancer patients may improve their ability to RTW after treatment
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