Abstract Background: Little is known about work participation in breast cancer survivors (BCSs) beyond two years after diagnosis. This study aims to report work status at diagnosis and at eight years post-diagnosis in a nation-wide sample of BCSs, investigate factors associated with reduced work status, and report on self-perceived reasons for reduced work status or disability pension. Material and Methods: Women diagnosed with stage I-III BC at the age of 20-65 years in 2011 or 2012 were invited to participate (n=2,803), of which 49 % (n=1361) responded. The response rate was 49 % (n=1361). A final sample of 1324 BCSs with complete questionnaire information regarding work status were included in the present study. Logistic regression analyses were applied to identify factors associated with reduced work status. Results At diagnosis, 78% (n=1038) of the BCSs were in paid work, 12% received disability pension and 4 % held early retirement. At survey, 42% of the BCSs were in paid work, 26% held disability pension and 28% were retired. Of the 845 survivors who were in paid work at diagnosis and within working age at survey, 63% maintained their work status, while 37% reduced their work status. Living with children (OR 0.4, p=.007), older age (OR 1.2, p<.001), chemotherapy (OR 2.9, p=.013), three or more comorbid conditions (OR 2.2, p=.016), higher level of fatigue (OR 1.02, p<.001), symptoms of cognitive dysfunction (OR 0.9, p=.038) and higher degree of neuroticism (OR 1.2, p=.012) were associated with reduced work status. BC, complaints and late effects after BC were reported as the main or partial reason for reduced work status and disability. Conclusion Almost two thirds of BCSs in working age who were in paid work at diagnosis remained in the paid work force eight years later. Individual characteristics and various health complaints including fatigue end cognitive dysfunction were associated with reduced work status from diagnosis to survey. Evaluation and treatment of these conditions are warranted, with the ultimate aim of improving work maintenance in long-term BCSs. Citation Format: Synne-Kristin Hoffart Bøhn, Kathrine Vandraas, Cecilie E Kiserud, Alv A Dahl, Marianne Ewertz, Hanne Cathrine Lie, Ragnhild Falk, Kristin Valborg Reinertsen. Work status changes and associated factors in a nation-wide sample of 1324 Norwegian long-term breast cancer survivors [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr PD5-09.