Return to work of breast cancer survivors: a systematic review of intervention studies

Jl Hoving,Mhw Frings-Dresen,Mla Broekhuizen

doi:10.1186/1471-2407-9-117

Abstract

BackgroundBreast cancer management has improved dramatically in the past three decades and as a result, a population of working age women is breast cancer survivor. Interventions for breast cancer survivors have shown improvements in quality of life and in physical and psychological states. In contrast, efforts aimed at stimulating re-employment and return-to-work interventions for breast cancer survivors have not kept pace. The objective of this review was to study the effects and characteristics of intervention studies on breast cancer survivors in which the outcome was return to work.MethodsThe Cochrane Controlled Trials Register (The Cochrane Library, Issue 4, 2006), Medline, Ovid, EMBASE and PsychInfo were systematically searched for studies conducted between 1970 to February 2007. Intervention studies for female breast cancer survivors that were focused on return to work were included.ResultsOur search strategy identified 5219 studies. Four studies out of 100 potentially relevant abstracts were selected and included 46–317 employed women who had had mastectomy, adjuvant therapy and rehabilitation, with the outcome return to work. The intervention programs focused on improvement of physical, psychological and social recovery. Although a substantial percentage (between 75% to 85%) of patients included in these studies returned to work after rehabilitation, it is not clear whether this proportion would have been lower for patients without counseling or exercise, or any other interventions, as three out of four studies did not include a comparison group.ConclusionThe most important finding of this review is the lack of methodologically sound intervention studies on breast cancer survivors with the outcome return to work. Using evidence from qualitative and observational studies on cancer and the good results of intervention studies on return to work programs and vocational rehabilitation, return to work interventions for breast cancer survivors should be further developed and evaluated.

Highlights

Breast cancer management has improved dramatically in the past three decades and as a result, a population of working age women is breast cancer survivor
A recent surveillance study by Bouknight et al (2006) in the US, found 82% of breast cancer survivors returned to work after 12 months [24]
There is a wide range in disability outcomes among breast cancer survivors, even when they have had the same disease with equal severity [26]

Summary

Introduction

Breast cancer management has improved dramatically in the past three decades and as a result, a population of working age women is breast cancer survivor. Interventions for breast cancer survivors have shown improvements in quality of life and in physical and psychological states. Efforts aimed at stimulating re-employment and return-to-work interventions for breast cancer survivors have not kept pace. The objective of this review was to study the effects and characteristics of intervention studies on breast cancer survivors in which the outcome was return to work. Breast cancer detection and care management have undergone dramatic changes in the past three decades. Survival of breast cancer has become more frequent because women are increasingly diagnosed with early-stage disease and screening. The overall five-year survival rate is above 85% in The Netherlands [1] and USA [2]

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