Abstract P2-14-05: Is It Only a Question of Willpower? Factors Associated with Job Resumption after Primary Breast Cancer Treatment — A Prospective Mono-Centre Trial
Authors: Strada MR , Palumbo R , Frascaroli M , Albanese D , Poggi G , Bernardo A , Amatu A , Teragni C , Jedrychowska I , Malagò G , Petracca M , Bernardo G. 
Published: April 2011

Background: The work experience of women who have had a breast cancer (BC) is still an unexplored area of survivorship research, while the number of women who are employed when they are diagnosed with BC is growing. The purpose of our research was to examine the impact of sociodemographic, clinical and employment variables on return to work after breast cancer.

Patients and methods: Eligibility requirements included histologically verified newly invasive breast carcinoma, age between 18 and 60 years, being employed in the month of diagnosis, and being able to respond an interview by questionnaires. The first questionnaire included three sets of questions focused on sociodemographic and personal characteristics, disease-related variables, and the work history. Quality of life and quality of work were assessed by EORTC QLQ-C30 and EORTC-Br23 and FACT-an and VBBA questionnaires. Follow-up assessments were carried out at 6 months, 12 months, 24 months and 30 months after surgery.

Results: Two hundred thirty-five eligible patients referring at our Institution between January 2002 and December 2006 with a newly diagnosed BC were enrolled in this longitudinal prospective study. Median age was 45 years (68 patients &gt;45, 63 &lt;45), more than high school degree in 70%; post-surgery complications in &lt;50%, treatment-related side-effects in 38% of patients receiving adjuvant systemic therapies. The median time of disease duration was &gt; 60 days in 73% of patients. At baseline 80% of women were full-time, and 25% were self-employed; 47% of them were flexible hours working. At 24 months after BC diagnosis, 178 women (75.7%) had returned to work. Most were state-employed (85%), full-time working in 69% of cases, and &gt; 60% did an intellectual job; 63% benefited from flexible hours working. Discrimination because of cancer diagnosis was reported by 35% of patients and occupational intervention by 25% of re-employed women. Among the 57 women who had not returned to work after 24 months from diagnosis, 21 were still sick-listed, 18 received a disability work pension, 11 were early retired, and 7 were out of work. Statistical analysis showed that the duration of disease (odds ratio= 2.96; 95%CI 1.25 to 7.03) and the nature of work (odds ratio= 3.9; 95%CI 1.57 to 9.82) were the strongest predictors factors of work disability. Analysis of factors related to quality of life and quality of work showed that fatigue adversely affected the return to work in our sample, while perceived good quality of job was associated with a greater likelihood of work resumption (p&lt;=0.001).

Conclusions: Our research confirm that work situation after BC is still an ongoing critical issue. In the present longitudinal study strictly disease-and work-related variables, as disease duration and nature of work, were the strongest predictors factors of work disability in employed BC survivors. While waiting for development of new therapeutic options that will leave even fewer survivors with work-related disabilities, the main challenge remains to identify survivors with working problems at all stages of survivorship, aiming to a better management of disabilities and improved occupational rehabilitation.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P2-14-05.