Journal of Occupational Rehabilitation

, Volume 20, Issue 1, pp 49–58 | Cite as

Factors Related to Return to Work by Women with Breast Cancer in Northern France

  • Sophie Quinton Fantoni
  • Charlotte Peugniez
  • Alain Duhamel
  • Joanna Skrzypczak
  • Paul Frimat
  • Ariane Leroyer


Introduction Earlier diagnosis and better treatment have increased the survival rates of breast cancer patients. This warrants research on return to work of cancer survivors, especially about subjective factors because they affect the mental desire to return to work. Moreover, knowledge in this issue is very limited in France. Objectives This study aims to explore the objective and subjective factors that affect whether and when women with breast cancer return to work. Methods 379 women with breast cancer aged 18–60 years who were working at the time of diagnosis responded to a 45 item questionnaire. The questionnaire had personal characteristics, disease-related characteristics and work-related ones. Multivariate logistic regressions were run to determine the association of these factors and return to work and time until return to work. Results During a median follow-up of 36 months, 82.1% of the 379 women who had worked before their diagnosis returned to work after a median sick leave of 10.8 months. Older age, lower educational level, chemotherapy, radiotherapy, lymphoedema, psychological or organizational self-perceived constraints related to their former job, and the lack of moral support from work colleagues both limited and delayed return to work. Conclusion The resumption of work by women with breast cancer depends on many factors, not all of them medical. The self-perceived factors must be considered: first to help support these women during their sick leave, while taking into account elements that may hinder early return to work; second to initiate a work resumption support process which takes into account both the person and her environment.


Breast-cancer Return to work Absence duration Self-perceived factors 



This study was conducted with logistic support from the University of Lille 2, through the H. WAREMBOURG Faculty of Medicine, the Occupational Medicine Laboratory, the Center for Advisory Resources in Occupational Health, the Unit of Occupational and Environmental Disease of the CHRU-ISTNF (Occupational Health Institute of Northern France), and financial support from the Nord-Pas-de-Calais region.


  1. 1.
    Francis P, Crown J, Di Leo A, et al. Adjuvant chemotherapy with sequential or concurrent Anthracycline and Docetaxel: Breast International Group 02–98 randomized trial. J Natl Cancer Inst. 2008;100:121–33.CrossRefPubMedGoogle Scholar
  2. 2.
    The Breast International Group (BIG). A comparaison of Letrozole and Tamoxifen in postmenopausal women with early breast cancer. N Engl J Med. 2005;353:2747–57.CrossRefGoogle Scholar
  3. 3.
    Winer E, Gralow J, Diller L, et al. Clinical cancer advances 2008: major research advances in cancer treatment, prevention and screening—a report from the American society of clinical oncology. J Clin Oncol. 2008;27:812–26.CrossRefPubMedGoogle Scholar
  4. 4.
    Hendrick RE, Smith RA. Tutledge JH et al. Benefit of sceening mammography in women aged 40–49: a new meta analysis of randomized controlled trials. J Natl Cancer Inst. 1997;22:87–92.Google Scholar
  5. 5.
    Bradley CJ, Bednarek HL, Neumark D. Breast cancer and women’s labor supply. Health Serv Res. 2002;37:1309–28.CrossRefPubMedGoogle Scholar
  6. 6.
    Bloom JR, Stewart SL, Chang S, Banks PJ. Then and now: quality of life of young breast cancer survivors. Psychooncology. 2004;13:147–60.CrossRefPubMedGoogle Scholar
  7. 7.
    Maunsell E, Drolet M, Brisson J, et al. Work situation after breast cancer: results from a population-based study. J Natl Cancer Inst. 2004;96:1813–22.PubMedCrossRefGoogle Scholar
  8. 8.
    Lauzier S, Maunsell E, Drolet M, et al. Wage losses in the year after breast cancer: extent and determinants among Canadian women. J Natl Cancer Inst. 2008;100:321–32.CrossRefPubMedGoogle Scholar
  9. 9.
    Balak F, Roelen CA, Koopmans PC, et al. Return to work after early-stage Breast cancer: a cohort study into the effects of treatment and cancer-related symptoms. J Occup Rehabil. 2008;18:267–72.CrossRefPubMedGoogle Scholar
  10. 10.
    Roelen CA, Koopmans PC, De Graaf JH, et al. Sickness absence and return to work rates in women with breast cancer. Int Arch Occup Environ Health. 2009;82:543–6.CrossRefPubMedGoogle Scholar
  11. 11.
    Amir Z, Brocky J. Cancer survivorship and employment:epidemiology. Occup Med. 2009;59:373–7.CrossRefGoogle Scholar
  12. 12.
    Short PF, Vasey JJ, Tunceli K. Employment pathways in a large cohort of adult cancer survivor. Cancer. 2005;103:1292–301.CrossRefPubMedGoogle Scholar
  13. 13.
    Taskila T, Lindohm ML. Factors affecting cancer survivors’ employment and work ability. Acta Oncol. 2007;46(4):446–51.CrossRefPubMedGoogle Scholar
  14. 14.
    Bradley C, Oberst K, Schenk M. Absenteeism from work: the experience of employed breast and prostate cancer patients in the months following diagnosis. Psychooncology. 2006;15:739–47.CrossRefPubMedGoogle Scholar
  15. 15.
    Taskila-Abrandt T, Martikainen R, Virtanen SV, Pukkala E, Hietanen P, Lindbohm ML. The impact of education and occupation on the employment status of cancer survivors. Eur J Cancer. 2004;40:2488–93.CrossRefGoogle Scholar
  16. 16.
    De Boer A, Ojajärvi A, et al. Cancer survivors and unemployment: a meta-analysis and meta-regression. JAMA. 2009;301(7):753–62.CrossRefPubMedGoogle Scholar
  17. 17.
    Satariano WA, DeLorenze G. The likelihood of returning to work after breast cancer. Public Health Rep. 1996;111:236–43.PubMedGoogle Scholar
  18. 18.
    Spelten ER, Verbeek JH, Vitterhoeve AL. Cancer, fatigue and the return of patients to work-a prospective cohort study. Eur J Cancer. 2003;39:1562–7.CrossRefPubMedGoogle Scholar
  19. 19.
    Pryce J, Munir F, Haslam C. Cancer survivorship and work: symptoms, supervisor response, co-worker disclosure and work-adjustment. J Occup Rehabil. 2007;17:83–92.CrossRefPubMedGoogle Scholar
  20. 20.
    Bouknight R, Bradley C, Luo Z. Correlates of return to work for breast cancer survivors. J Clin Oncol. 2006;24:345–53.CrossRefPubMedGoogle Scholar
  21. 21.
    Drolet M, Maunsell E, Brisson J, et al. Not working 3 years after breast cancer: predictors in a population-based study. J Clin Oncol. 2005;23:8305–12.CrossRefPubMedGoogle Scholar
  22. 22.
    Steiner JF, Cavender TA, Main DS, Bradley CJ. Assessing the impact of cancer on work outcomes: what are the research needs? Cancer. 2004;101:1703–10.CrossRefPubMedGoogle Scholar
  23. 23.
    Johnsson A, Fornander T, Olsson M, Nystedt M, Johansson H, Rutqvist LE. Factors associated with return to work after breast cancer treatment. Acta Oncol. 2007;46(1):90–6.CrossRefPubMedGoogle Scholar
  24. 24.
    Johnsson A, Fornander T, Rutqvist LE, et al. Predictors of return to work ten months after primary breast cancer surgery. Acta Oncol. 2009;48:93–8.CrossRefPubMedGoogle Scholar
  25. 25.
    Kennedy F, Haslam C, Munir F, Pryce J. Returning to work following cancer: a qualitative exploratory study into the experience of returning to work following cancer. Eur J Cancer Care. 2006;16:17–25.CrossRefGoogle Scholar
  26. 26.
    Sawyer M, Spencer D. On the definition of involuntary unemployment. J Socio-Econom. 2008;37:718–35.CrossRefGoogle Scholar
  27. 27.
    McWayne J, Heiney SP. Psychologic and social sequelae of secondary lymphedema. Cancer. 2005;104:457–66.CrossRefPubMedGoogle Scholar
  28. 28.
    Engel J, Kerr J, Schlesinger-Raab A, Sauer H. Axilla surgery severely affects quality of life: results of 5-year prospective study in breast cancer patients. Breast Cancer Res Treat. 2003;79:47–57.CrossRefPubMedGoogle Scholar
  29. 29.
    Steiner JF, Cavender TA, Nowels CT, et al. The impact of physical and psychosocial factors on work characteristics after cancer. Psycho-Oncology. 2008;17(2):138–47.CrossRefPubMedGoogle Scholar
  30. 30.
    Berkman LF, Macintyre S. The measurement of social class in health studies: old measures and new formulations. In: Kogevinas M, Pearce N, Susser M, Bofetta P, editors. Social inequalities and cancer. Lyon: IARC Scientific Publications; 1997. p. 51.Google Scholar
  31. 31.
    Parizot I, Chauvin P, Paugam S. The moral career of poor peoples in free clinics. Soc Sci Med. 2005;61:1369–80.CrossRefPubMedGoogle Scholar
  32. 32.
    Spelten ER, Sprangers MAG, Verbeek JHAM. Factors reported to influence the return to work of cancer survivors: a literature review. Psycho-Oncology. 2002;11:124–31.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Sophie Quinton Fantoni
    • 1
  • Charlotte Peugniez
    • 2
  • Alain Duhamel
    • 3
  • Joanna Skrzypczak
    • 1
  • Paul Frimat
    • 3
  • Ariane Leroyer
    • 3
  1. 1.Department of Occupational MedicineCHRU Lille, Université Lille 2Lille CedexFrance
  2. 2.Department of Breast DiseaseCentre Oscar Lambret, CHRU LilleLilleFrance
  3. 3.Department of Occupational MedicineUniversité Lille Nord de France, UDSL, CHRU LilleLille CedexFrance

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