Abstract PO3-11-06: Return to work in Brazilian women on adjuvant endocrine therapy
Authors: Assad-Suzuki Daniele , Shimada Andrea , Santos Danielle , Souza Cristiano , Moura Fernanda , Oliveira Sulene , Galvão Anna Luiza , Souza Bruno , Castro Amanda , Andrade Monalisa , Beckedorff Yuri , Magalhães Maria Cristina , Paiva Carlos , Resende Heloísa , Pereira Daniela , Rodrigues Angelica , Rosa Daniela , Barroso-Sousa Romualdo 
Published: May 2024

Abstract
Background: Breast cancer is the most common cancer in women and its diagnosis and treatment may adversely impact the return to work (RTW). Previous work showed that RTW varies from as low at 27% to as high as 93%. There are few data about RTW in Latin America population. This study aims to investigate the RTW in Brazilian woman with early breast cancer treated with adjuvant endocrine therapy (ET) and its relations to patients’ characteristics, duration of ET, healthcare insurance, quality of life (QOL), sexual disfunction and adherence. Methodology: Women with a past history of early-stage estrogen receptor-positive (ER+) invasive carcinoma of the breast on adjuvant endocrine therapy for at least 6 months were invited to participate in this study and evaluated about RTW. We interviewed patients and asked about employment before cancer diagnosis and about absence from work (yes/no) after diagnosis, return to work (yes/no), time off (&lt; 06 months, 6-12 months, 13-24 months, &gt; 24 months), and difficulties in RTW (yes/no). EORTC QLQ C30 and BR-23, female sex function index questionnaires (FSFI) and adherence to endocrine therapy (MMAS-8) were evaluated. Demographic and medical information, having or not private health insurance (yes versus public), degree of education (completed high school vs not) were reviewed from medical records. Data collection was done with RedCap software. Qualitative variables were compared between groups using the Chi-square or exact Chi-square test and for quantitative variables the non-parametric Mann-Whitney test was used. Multivariable analysis was performed using Poisson regression. P &lt; 0.05 was considered significant. Analyzes were performed in SAS 9.4. Results: From June 2021 to May 2023, a total of 461 women with ER+ early-stage breast cancer from 12 Brazilian institutions were included in this analysis. The mean age was 56.02 years (range 22-93 ), 47.7% were non-white and 38.7% were premenopausal. A total of 233 women (50.6%) had private insurance and the remaning were treated in public institutions. Median duration of ET usewas 2.78 years (range 6 months- 9.61 years). A total of 266 (64.88%) of women worked before cancer diagnosis and were evaluated about RTW. RTW rates at 6 months, 12 months and 24 months after diagnosis were 32.7%, 53% and 69.9% respectively. A total of 31.2% of women did not RTW at 2 years. A total of 53 (37.5%) of woman reported to face difficulties to RTW. Characteristics associated with RTW were age &gt;60 years (p=0.004), white race (p=0.014), higher education level (p&lt; 0.0001), stage I disease (p=0.018), private healthcare insurance (p&lt; 0.0001). In the multivariable analysis, not having private health insurance, yonger age, lower EORTC QLQ-C30 physical functioning score and higher EORTC QLQ-BR23 arm symptoms scores were associated with not returning to work in this population (p &lt; 0.05). Conclusion: Almost one third of the patients who were employed before cancer diagnosis did not RTW after treatment in Brazil. At 12 months, RTW rate was 53% higher than previous data in Latin America. Healthcare insurance, age and quality of life were related to RTW. It is crucial to identify the barriers and improve work conditions to increase RTW after breast cancer treatment as RTW have been shown to be beneficial to patients’ physical, mental health and quality of life.
Variables with adjusted prevalence ratios for the occurrence of absence from work
XX XX PR: Prevalence ratio; EORTC : European Organisation for Research and Treatment of Cancer
XX XX
Citation Format: Daniele Assad-Suzuki, Andrea Shimada, Danielle Santos, Cristiano Souza, Fernanda Moura, Sulene Oliveira, Anna Luiza Galvão, Bruno Souza, Amanda Castro, Monalisa Andrade, Yuri Beckedorff, Maria Cristina Magalhães, Carlos Paiva, Heloísa Resende, Daniela Pereira, Angelica Rodrigues, Daniela Rosa, Romualdo Barroso-Sousa. Return to work in Brazilian women on adjuvant endocrine therapy [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-11-06.