Abstract
Purpose
Breast cancer survivors in their employment years are likely to try to go back to work after the primary treatment. Because the literature on return to work among breast cancer survivors is limited, we have undertaken a review of the literature to summarize what is known, including identifying important contributing variables and outcomes. This knowledge may be used to develop hypotheses and potential interventions to support breast cancer survivors who wish to return to work.
Method
We searched the following databases: CINAHL, MEDLINE, SCOUP, and PUBMED, within a 10-year timeframe (2004 to 2014).
Results
The majority of reviewed articles (N = 25) focused on three outcomes: return-to-work period, work ability, and work performance. The most frequently studied independent variables were collapsed into the following groups: health and well-being, symptoms and functioning, work demands and work environment, individual characteristics, and societal and cultural factors. Gaps in the literature include evidence of effective interventions to support return to work among breast cancer survivors and research to better understand the roles of government and business-related policy.
Conclusion
All the studies reported a reduced work engagement and work ability. Employment status and work performance is associated with a combination of individual factors, work environment, culture, and resources.
Implications
Significant gaps are apparent in the literature addressing breast cancer survivorship and return to work. This is a complex problem and it will likely require interdisciplinary research teams to develop effective and feasible interventions for this population.
Similar content being viewed by others
References
Global Cancer Facts & Figures 2nd Edition (2011) American Cancer Society. http://cancer.org/acs/groups/content/@epidemiologysurveilance/documents/document/acspc-027766.pdf. Accessed 4/25/2014
Breast Cancer Facts & figures 2013-2014 (2013) Atlanta: American Cancer Society, Inc. http://cancer.org/acs/groups/content/@research/documents/document/acspc-042725.pdf. Accessed 9/20/2014
Richardson A, Addington-Hall J, Amir Z, Foster C, Stark D, Armes J, Brearley SG, Hodges L, Hook J, Jarrett N, Stamataki Z, Scott I, Walker J, Ziegler L, Sharpe M (2011) Knowledge, ignorance and priorities for research in key areas of cancer survivorship: findings from a scoping review. Br J Cancer 105(SUPPL. 1):S82–S94
Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z,Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2012, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2012/, based on November 2014 SEER data submission, posted to the SEER web site, April 2015.
Petersson LM, Wennman-Larsen A, Nilsson M, Olsson M, Alexanderson K (2011) Work situation and sickness absence in the initial period after breast cancer surgery. Acta Oncol 50(2):282–288
Johnsson A, Fornander T, Rutqvist LE, Vaez M, Alexanderson K, Olsson M (2009) Predictors of return to work ten months after primary breast cancer surgery. Acta Oncol 48(1):93–98
Balak F, Roelen CA, Koopmans PC, Ten Berge EE, Groothoff JW (2008) Return to work after early-stage breast cancer: a cohort study into the effects of treatment and cancer-related symptoms. J Occup Rehabil 18(3):267–272
Molina Villaverde R, Feliu Batlle J, Villalba Yllan A, Jimenez Gordo AM, Redondo Sanchez A, San Jose Valiente B, Gonzalez Baron M (2008) Employment in a cohort of breast cancer patients. Occup Med (Oxford) 58(7):509–511
Fantoni SQ, Peugniez C, Duhamel A, Skrzypczak J, Frimat P, Leroyer A (2010) Factors related to return to work by women with breast cancer in northern France. J Occup Rehabil 20(1):49–58
Hansen JA, Feuerstein M, Calvio LC, Olsen CH (2008) Breast cancer survivors at work. J Occup Environ Med 50(7):777–784
Hauglann B, Benth JS, Fossa SD, Dahl AA (2012) A cohort study of permanently reduced work ability in breast cancer patients. J Cancer Surviv 6(3):345–356
Quinlan E, Thomas-MacLean R, Hack T, Kwan W, Miedema B, Tatemichi S, Towers A, Tilley A (2009) The impact of breast cancer among Canadian women: disability and productivity. Work 34(3):285–296
Carlsen K, Jensen AJ, Rugulies R, Christensen J, Bidstrup PE, Johansen C, Huitfeldt Madsen IE, Dalton SO (2013) Self-reported work ability in long-term breast cancer survivors. A population-based questionnaire study in Denmark. Acta Oncol 52(2):423–429
Lavigne JE, Griggs JJ, Tu XM, Lerner DJ (2008) Hot flashes, fatigue, treatment exposures and work productivity in breast cancer survivors. J Cancer Surviv 2(4):296–302
Lerner D, Amick Iii BC, Rogers WH, Malspeis S, Bungay K, Cynn D (2001) The work limitations questionnaire. Med Care 39(1):72–82
Calvio L, Peugeot M, Bruns GL, Todd BL, Feuerstein M (2010) Measures of cognitive function and work in occupationally active breast cancer survivors. J Occup Environ Med 52(2):219–227
Désiron HAM, Donceel P, de Rijk A, Van Hoof E (2013) A conceptual-practice model for occupational therapy to facilitate return to work in breast cancer patients. J Occup Rehabil 23(4):516–526. doi:10.1007/s10926-013-9427-z
Mehnert A, de Boer A, Feuerstein M (2013) Employment challenges for cancer survivors. Cancer 119(11, Suppl):2151–2159. doi:10.1002/cncr.28067
Duijts S, Spelten E, Verbeek J (2014) Behavioral determinants of employment status in cancer patients. In: The Handbook of Behavioral Medicine. John Wiley & Sons, Ltd, pp 825-849. doi:10.1002/9781118453940.ch39
Johnsson A, Fornander T, Rutqvist LE, Olsson M (2011) Work status and life changes in the first year after breast cancer diagnosis. Work 38(4):337–346
Ahn E, Cho J, Shin DW, Park BW, Ahn SH, Noh DY, Nam SJ, Lee ES, Yun YH (2009) Impact of breast cancer diagnosis and treatment on work-related life and factors affecting them. Breast Cancer Res Treat 116(3):609–616
Todd BL, Feuerstein EL, Feuerstein M (2011) When breast cancer survivors report cognitive problems at work. Int J Psychiatry Med 42(3):279–294
Schmalenberger S, Gessert CE, Giebenhain JE, Starr LD (2012) Working after breast cancer treatment: lessons from musicians. Med Probl Performing Artists 27(4):175–180
Schmalenberger S, Gessert CE, Giebenhain JE, Starr LD (2012) Livelihood vs. life: the occupational well-being of women musician survivors of breast cancer. Med Probl Performing Artists 27(1):15–20
Blinder VS, Murphy MM, Vahdat LT, Gold HT, de Melo-Martin I, Hayes MK, Scheff RJ, Chuang E, Moore A, Mazumdar M (2012) Employment after a breast cancer diagnosis: a qualitative study of ethnically diverse urban women. J Community Health 37(4):763–772
Boykoff N, Moieni M, Subramanian SK (2009) Confronting chemo brain: an in-depth look at survivors’ reports of impact on work, social networks, and health care response. J Cancer Surviv 3(4):223–232
Breckenridge LM, Bruns GL, Todd BL, Feuerstein M (2012) Cognitive limitations associated with tamoxifen and aromatase inhibitors in employed breast cancer survivors. Psychooncology 21(1):43–53
Cheung YT, Tan EH, Chan A (2012) An evaluation on the neuropsychological tests used in the assessment of postchemotherapy cognitive changes in breast cancer survivors. Support Care Cancer 20(7):1361–1375
Munir F, Burrows J, Yarker J, Kalawsky K, Bains M (2010) Women’s perceptions of chemotherapy-induced cognitive side affects on work ability: a focus group study. J Clin Nurs 19(9–10):1362–1370
Oberst K, Bradley CJ, Gardiner JC, Schenk M, Given CW (2010) Work task disability in employed breast and prostate cancer patients. J Cancer Surviv 4(4):322–330
Ottati A, Feuerstein M (2013) Brief self-report measure of work-related cognitive limitations in breast cancer survivors. J Cancer Surviv 7(2):262–273
Von Ah D, Habermann B, Carpenter JS, Schneider BL (2013) Impact of perceived cognitive impairment in breast cancer survivors. Eur J Oncol Nurs 17(2):236–241
Mujahid MS, Janz NK, Hawley ST, Griggs JJ, Hamilton AS, Katz SJ (2010) The impact of sociodemographic, treatment, and work support on missed work after breast cancer diagnosis. Breast Cancer ResTreat 119(1):213–220
Blinder VS, Patil S, Thind A, Diamant A, Hudis CA, Basch E, Maly RC (2012) Return to work in low-income Latina and non-Latina white breast cancer survivors: a 3-year longitudinal study. Cancer 118(6):1664–1674
Tan FL, Loh SY, Su TT, Veloo VW, Ng LL (2012) Return to work in multi-ethnic breast cancer survivors—a qualitative inquiry. Asian Pac J Cancer Prev: Apjcp 13(11):5791–5797
Hakanen JJ, Lindbohm ML (2008) Work engagement among breast cancer survivors and the referents: the importance of optimism and social resources at work. J Cancer Surviv 2(4):283–295
Tamminga SJ, de Boer AG, Verbeek JH, Frings-Dresen MH (2012) Breast cancer survivors’ views of factors that influence the return-to-work process—a qualitative study. Scand J Work Environ Health 38(2):144–154
Tiedtke C, de Rijk A, Donceel P, Christiaens MR, de Casterle BD (2012) Survived but feeling vulnerable and insecure: a qualitative study of the mental preparation for RTW after breast cancer treatment. BMC Public Health 12:538
Tiedtke C, Donceel P, Knops L, Desiron H, Dierckx de Casterle B, de Rijk A (2012) Supporting return-to-work in the face of legislation: stakeholders’ experiences with return-to-work after breast cancer in Belgium. J Occup Rehabil 22(2):241–251
Hoving JL, Broekhuizen ML, Frings-Dresen MH (2009) Return to work of breast cancer survivors: a systematic review of intervention studies. BMC Cancer 9:117
Fismen K, Osland IJ, Fismen E, Borge L, Martinsen EW, Hjort P, Iversen OE, Stanghelle JK (2000) [Rehabilitation of women with breast cancer]. Tidsskrift for den Norske laegeforening: tidsskrift for praktisk medicin, ny raekke 120(23):2749–2754
Maguire P, Brooke M, Tait A, Thomas C, Sellwood R (1983) The effect of counselling on physical disability and social recovery after mastectomy. Clin Oncol 9(4):319–324
Sachs SH, Davis JM, Reynolds SA, Spagnola M, Hall P, Bloch A (1980) Postmastectomy rehabilitation in a community hospital. J Fam Pract 11(3):395–401
Winick L, Robbins GF (1977) Physical and psychologic readjustment after mastectomy: an evaluation of memorial hospitals’ PMRG program. Cancer 39(2):478–486
Hubbard G, Gray NM, Ayansina D, Evans JM, Kyle RG (2013) Case management vocational rehabilitation for women with breast cancer after surgery: a feasibility study incorporating a pilot randomised controlled trial. Trials [Electronic Resource] 14:175
Feuerstein M, Todd BL, Moskowitz MC, Bruns GL, Stoler MR, Nassif T, Yu X (2010) Work in cancer survivors: a model for practice and research. J Cancer Surviv 4(4):415–437
Assis MR, Marx AG, Magna LA, Ferrigno IS (2013) Late morbidity in upper limb function and quality of life in women after breast cancer surgery. Braz J Phys Ther 17(3):236–243
Devoogdt N, Van Kampen M, Christiaens MR, Troosters T, Piot W, Beets N, Nys S, Gosselink R (2011) Short- and long-term recovery of upper limb function after axillary lymph node dissection. European Journal of Cancer Care 20(1):77–86. doi:10.1111/j.1365-2354.2009.01141.x
Hayes SC, Rye S, Battistutta D, DiSipio T, Newman B (2010) Upper-body morbidity following breast cancer treatment is common, may persist longer-term and adversely influences quality of life. Health Qual Life Outcomes 8. doi:10.1186/1477-7525-8-92
Stubblefield MD, Keole N (2014) Upper body pain and functional disorders in patients with breast cancer. PM and R: J Inj, Funct, Rehabil 6(2):170–183. doi:10.1016/j.pmrj.2013.08.605
Boyages J, Kalfa S, Xu Y, Koelmeyer L, Mackie H, Viveros H, Taksa L, Gollan P (2016) Worse and worse off: the impact of lymphedema on work and career after breast cancer. SpringerPlus 5(1):1–8. doi:10.1186/s40064-016-2300-8
Peugniez C, Fantoni S, Leroyer A, Skrzypczak J, Duprey M, Bonneterre J (2011) Return to work after treatment for breast cancer: single center experience in a cohort of 273 patients. Bull Cancer 98(7):E69–E79
Chachaj A, Malyszczak K, Pyszel K, Lukas J, Tarkowski R, Pudelko M, Andrzejak R, Szuba A (2010) Physical and psychological impairments of women with upper limb lymphedema following breast cancer treatment. Psychooncology 19(3):299–305. doi:10.1002/pon.1573
Dawes DJ, Meterissian S, Goldberg M, Mayo NE (2008) Impact of lymphoedema on arm function and health-related quality of life in women following breast cancer surgery. J Rehabil Med 40(8):651–658. doi:10.2340/16501977-0232
Hormes JM, Bryan C, Lytle LA, Gross CR, Ahmed RL, Troxel AB, Schmitz KH (2010) Impact of lymphedema and arm symptoms on quality of life in breast cancer survivors. Lymphology 43(1):1–13
Pyszel A, Malyszczak K, Pyszel K, Andrzejak R, Szuba A (2006) Disability, psychological distress and quality of life in breast cancer survivors with arm lymphedema. Lymphology 39(4):185–192
Smoot B, Wong J, Cooper B, Wanek L, Topp K, Byl N, Dodd M (2010) Upper extremity impairments in women with or without lymphedema following breast cancer treatment. J Cancer Surviv 4(2):167–178. doi:10.1007/s11764-010-0118-x
Taghian NR, Miller CL, Jammallo LS, O’Toole J, Skolny MN (2014) Lymphedema following breast cancer treatment and impact on quality of life: a review. Crit Rev Oncol Hematol 92(3):227–234. doi:10.1016/j.critrevonc.2014.06.004
Henry NL, Griggs JJ (2009) Complexities of adjuvant endocrine therapy in young premenopausal women. Oncol (Williston Park, NY) 23(6):482–487
Howard-Anderson J, Ganz PA, Bower JE, Stanton AL (2012) Quality of life, fertility concerns, and behavioral health outcomes in younger breast cancer survivors: a systematic review. J Natl Cancer Inst 104(5):386–405
Mortimer J, Behrendt CE (2013) Severe menopausal symptoms are widespread among survivors of breast cancer treatment regardless of time since diagnosis. Journal of palliative medicine 16 (9):1130–1134. doi:10.1089/jpm.2012.0585
Gupta P, Sturdee DW, Palin SL, Majumder K, Fear R, Marshall T, Paterson I (2006) Menopausal symptoms in women treated for breast cancer: the prevalence and severity of symptoms and their perceived effects on quality of life. Climacteric 9 (1):49-58. doi:10.1080/13697130500487224
Peppercorn J (2009) Breast cancer in women under 40. Oncol (Williston Park, NY) 23(6):465–474
Arroyo JM, Lopez ML (2011) Psychological Problems Derived from Mastectomy: A Qualitative Study. International Journal of Surgical Oncology Vol. 2011:132461. doi:10.1155/2011/132461
Przezdziecki A, Sherman KA, Baillie A, Taylor A, Foley E, Stalgis-Bilinski K (2013) My changed body: breast cancer, body image, distress and self-compassion. Psychooncology 22 (8):1872-1879. doi:10.1002/pon.3230
Anitei M, Chraif M, Vasile C, Enache RG (2012) The relationship between anxiety, depression and self-esteem in women with breast cancer after surgery. Procedia-Soc Behav Sci 33:124–127. doi:10.1016/j.sbspro.2012.01.096
Acknowledgments
It is acknowledged that no Veterans Affairs resources were used for the conduct of this work.
Author information
Authors and Affiliations
Corresponding authors
Ethics declarations
Conflict of interest
The authors declare that they have no conflicts of interest.
Ethical approval
This article does not contain any studies with human participants performed by any of the authors.
Electronic supplementary material
Supplementary Table 1
(DOCX 35 kb)
Rights and permissions
About this article
Cite this article
Sun, Y., Shigaki, C.L. & Armer, J.M. Return to work among breast cancer survivors: A literature review. Support Care Cancer 25, 709–718 (2017). https://doi.org/10.1007/s00520-016-3446-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00520-016-3446-1