Return to Work after Treatment for Breast Cancer: Single Center Experience in a Cohort of 273 Patients.

Abstract

Abstract Background: An increasing number of patients (pts) are treated for breast cancer during professional life. The aim of this study was to assess medical as well as socio-professional factors impacting on the likelihood of patients to return to work after treatment.Patients and methods: 1067 pts who were less than 60 years of age, and surgically treated in our institution between January 1, 2004 and December 31, 2005 received a questionnaire with medical, sociodemographic and professional items. An answer was obtained in 586 cases. After excluding in situ carcinoma, local relapses, bilateral tumors and pts without professional activity before treatment, 273 were evaluable. All the clinical files of these patients were reviewed. We studied return to work qualitatively (by univariate, then multivariate logistic regression) and quantitatively, by measuring time until return to work (by log-rank and then multivariate Cox model).Results: Overall, 79.8% of the patients returned to work after a median delay of 11.5 months. In the multivariate analysis, the factors affecting the return to work were: age (p<.0001), particularly pts >55 years returning to work in 58% of cases vs more than 80% in younger ones, education level (p<.001), colleagues support (p<.001), chemotherapy (p<.05), lymphedema (p<.01), and the physical (p=.01) and psychological constraints of the job (p<.01). Surprisingly, local pain with ankylosis of the shoulder was significant only in the univariate analysis (p<.0001). In the multivariate analysis, the factors affecting the delay between treatment and return to work were very similar: age (p<.01), education level (p<.0001), colleagues support (p<.0001), chemotherapy (p<0001), lymphedema (p<.01), and the professional constraints of the job (p<.0001). No significant difference was observed according to type of surgery, tumorectomy vs mastectomy, sentinel lymph node vs axillary clearance, radiation therapy or not, hormonotherapy or not.Conclusion: in our study, 80% of the pts with a professional activity before treatment returned to work; the factors affecting the return to work as well as its delay were: medical (chemotherapy and lymphedema), demographic (age) and socioprofessional (education level, which induces differences in the socio-professional groups, constraints of the job, colleagues support). We could not find any influence of the other treatments such as radiotherapy or hormonotherapy. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 1060.