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. 2025 Sep 14;17(9):e92301.
doi: 10.7759/cureus.92301. eCollection 2025 Sep.

Return to Work After Breast Cancer Diagnosis and Treatment in Uruguay: Challenges and Determining Factors

Natalia Camejo  1   2 , Cecilia Castillo  1 , Ivan Lyra  1   3 , Diego Ferreira  3 , Agustin Cabillon  1 , Dahiana Amarillo  1 , Guadalupe Herrera  4 , Lucia Delgado  3 , Gabriel Krygier  1
Affiliations

Return to Work After Breast Cancer Diagnosis and Treatment in Uruguay: Challenges and Determining Factors

Natalia Camejo et al. Cureus. .

Abstract

Introduction: In Uruguay, breast cancer (BC) is the most common malignancy in women and the leading cause of cancer-related mortality in the female population. It represents a significant public health problem. Improved survival, driven by early diagnosis and therapeutic advances, has brought new challenges related to quality of life, including return to work and domestic activities, which are key to full recovery and social reintegration.

Objective: To determine the rate of return to work in women with BC at least 24 months after diagnosis and to analyze associated factors. To evaluate the impact of diagnosis and treatment on household task performance and to compare quality of life according to work status and domestic performance, using the PROMIS Global Health v1.2 instrument.

Methods: A descriptive longitudinal study was conducted in patients ≥18 years, with stage I-III BC, treated at the Hospital Departamental de Soriano and Sanatorio Mautone. Sociodemographic, clinical, occupational, and domestic data were collected through a structured questionnaire. Quality of life was assessed with PROMIS Global Health v1.2. Chi-square, Fisher's exact, Mann-Whitney, and Kruskal-Wallis tests were used, with a significance level of 5%.

Results: A total of 128 women were included (median age at diagnosis: 58 years). Among the 74 employed at diagnosis, 60.8% returned to work. Non-return was associated with older age (65 vs. 55 years), lower education, manual labor, mastectomy, axillary dissection, chemotherapy, postoperative complications, arm pain, shoulder limitation, lymphedema, and functional impairment (p<0.05). Among those who returned, 51.1% reported difficulties, mainly physical and due to a lack of adapted tasks; this rose to 79.3% among those who did not return. Regarding domestic activities, 32.5% required greater effort, 32.5% reduced activities, and only 33.3% maintained the same level and effort. Patients who did not return to work or required more effort for household tasks had lower scores in physical health, mental health, global health, and usual activities in PROMIS compared to those maintaining work or domestic tasks without changes (p<0.01).

Conclusions: Return to work and domestic activities in BC survivors are influenced by physical, occupational, and treatment-related factors, and their absence is associated with lower quality of life. Integrating physical rehabilitation, management of sequelae, and vocational guidance into oncology follow-up, especially in resource-limited settings, is essential to promote functional recovery and overall well-being.

Keywords: adl (activities of daily living); breast neoplasms; cancer survivors; quality of life (qol); return-to-work.

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Conflict of interest statement

Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. Research Ethics Committee of the Hospital de Clínicas Dr. Manuel Quintela issued approval 158-23. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Results of the PROMIS Scale v1.2 Global Health according to household activity in 98 women
Figure 2
Figure 2. Associations between physical sequelae, employment outcomes, and quality of life
Note: Arrows represent associations, not causal pathways.
See this image and copyright information in PMC

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