Return to work (RTW) after breast cancer is associated with improved quality of life. The link between household characteristics and RTW remains largely unknown. The aim of this study was to examine the effect of the family situation on women’s RTW two years after breast cancer. We used data of a French prospective cohort of women diagnosed with stage I-III, primary breast cancer (CANTO, NCT01993498). Among women employed at diagnosis and under 57 years old, we assessed the association between household characteristics (living with a partner, marital status, number and age of economically dependent children, support by the partner) and RTW. Logistic regression models were adjusted for age, household income, stage, comorbidities, treatments and their side effects. Analyzes stratified by age and household income were performed to assess the association between household characteristics and RTW in specific subgroups. Among the 3004 patients included, women living with a partner returned less to work (OR = 0.63 [0.47–0.86]) and decreased their working time after RTW. Among the 2305 women living with a partner, being married was associated with decreased RTW among women aged over 50 (OR = 0.57 [0.34–0.95]). Having three or more children (vs. none) was associated with lower RTW among women with low household income (OR = 0.28 [0.10–0.80]). Household characteristics should be considered in addition to clinical information to identify vulnerable women, reduce the social consequence of cancer and improve their quality of life.

Purpose: This study assessed sustainable return to work (SRTW) of breast cancer survivors (BCS).Methods: We used data from the prospective French cohort, CANTO. We included 1811 stage I–III BCS who were 50 (OR = 0.59; 95%CI = 0.43–0.82), stage III (2.56; 1.70–3.85), tumour subtype HR+/HER2+ (0.61; 0.39–0.95), severe fatigue (1.45; 1.06–1.98), workplace accommodations (1.63; 1.14–2.33) and life priorities (0.71; 0.53–0.95). Unemployment was associated with age > 50 (0.45; 0.29–0.72), working in the public sector (0.31; 0.19–0.51), for a small company (3.00; 1.74–5.20) and having a fixed‐term contract (7.50; 4.74–11.86).Conclusions: A high number of BCS have periods of sick leave or unemployment after RTW. The determinants differ between sick leave and unemployment.Implications for cancer survivors: BCS need to be supported even after RTW, which should be regarded as a process.

Background We assessed the prevalence of self-reported perceived discrimination in the workplace after the end of treatment among breast cancer (BC) survivors and studied its association with social, health-related and work-related factors. Methods We used data from a French prospective cohort (CANcer TOxicities) including women diagnosed with stage I–III BC. Our analysis included 2130 women who were employed, <57 years old at BC diagnosis and were working 2 years afterwards. We assessed the association between social, health-related and work-related factors and perceived discrimination in the workplace using logistic regression models. Results Overall, 26% of women reported perceived discrimination in the workplace after the end of treatment. Women working for a small company, in the public sector or with better overall health status were less likely to report perceived discrimination. Women who benefited from easing dispositions at their workplace, who did not feel supported by their colleagues and those who returned to work because of fear of job loss were more likely to report perceived discrimination. Conclusions One in four BC survivors perceives discrimination in the workplace. Health and work-related factors are associated with increased likelihood of reporting perceived discrimination. Trial registration number NCT01993498.

Background: As survival rates among breast cancer patients improve there is an increasing need to address breast cancer survivors’ (BCS) issues, professional life being a key aspect. Return to work (RTW) of BCS has been largely studied, but studies on job maintenance and its determinants are scarce. We aim to study job maintenance after RTW and the associated factors among BCS. Methods: We used data from the CANTO cohort, a French prospective cohort of BCS. We included 1643 BCS aged <57 at diagnosis (dx) who returned to work two years after dx. We excluded self-employed BCS. Using multinomial logistic models, we assessed the association between activity status one year after they return to work. (i.e. active, sick leave, or unemployed, retired or invalidity) and sociodemographic, clinical, health status and work-related factors. Results: Overall, 87% of BCS were active, 10% were on sick leave and 3% were on unemployment, retirement or invalidity one year after they return to work. In the fully adjusted model being on sick leave was associated with stage III at dx (OR: 1.89, 95% CI: 1.11-3.22), being severely fatigued at the moment of returning to work (OR: 1.53, 1.04-2.27), and having workplace accommodations (OR: 1.79, 1.14-2.81). The unemployed, retired, invalidity status was negatively associated with professional life being more than or as important as one’s personal life (OR: 0.51, 0.26-0.98) and being <50 years old (OR: 0.51, 0.27-0.96), and positively associated with having a fixed-term contract (OR: 2.69, 1.39-5.18) and working for a small company (OR: 2.73, 1.24-6.02). Conclusions: A non-negligible proportion of BCS are non-active one year after they return to work. While clinical factors are associated with sick leave, work related factors are associated with the unemployed, retired, and invalidity status. RTW should not be regarded as the ultimate goal and future policies should focus on ensuring people are ready to return to work and maintain their jobs. Key messages: • A non-negligible proportion of breast cancer survivors are non-active one year after they return to work. • Future policies should ensure job maintenance along with return to work.

The aim of this study was to assess return to work (RTW) after breast cancer (BC) by baseline employment status. Using data from the CANTO cohort (NCT01993498), we examined RTW among women below age 57 at BC diagnosis 2 and 4 years after BC diagnosis. We also assessed continuous work between years 2 and 4 post-diagnosis. Poisson regression models investigated associations between baseline employment (self-employed vs. employees) and RTW outcomes, adjusting for clinical, sociodemographic, and work-related factors and quality of life. We used education (above high school; high school or lower) as a proxy to further distinguish between white collar self-employees vs. blue collar self-employees (vs. employees). About 8% of women were self-employed at diagnosis. RTW was slightly higher among the self-employed compared to employees 2 years ( N = 3178; PR = 1.04, 95%CI 0.98–1.10) and 4 years after diagnosis ( N = 2329; PR = 1.05, 0.99–1.12). This effect was limited to white collar self-employed women. Among those who returned to work 2 years after diagnosis ( N = 1683), self-employed women showed a 1.15 (1.01–1.31) higher prevalence of continuous work until year 4 post-diagnosis than employees. Self-employed women do not strongly differ from employees when assessing RTW at specific time points, however once returned to work, they experience fewer work interruptions than employees. This was observed in adjusted models, showing the intrinsic importance of job status in the RTW process. These findings highlight the importance of viewing RTW as an ongoing process, in order to provide appropriate and sustained support.