Eighty-seven (70.2%) of the 124 women surveyed returned to work after being diagnosed and treated for breast cancer, while 37 (29.8%) were unable to return. The majority of those who did not return to work indicated they wished to (78.4%). Patients treated in private healthcare systems had higher rates of returning to work compared to those in public systems. Developing depression after diagnosis and dissatisfaction with one's work were associated with lower rates of returning to work in multivariate analysis.

1. RESEARCH POSTER PRESENTATION DESIGN © 2019
www.PosterPresentations.com
BACKGROUND
METHODOLOGY
Eighty-seven (70.2%) women returned to work and 37
(29.8%) were unable to return; 21.8% stayed away from
work for < 6 months, 26.6% for 6-12 months, 22.6% for 12-24
months, 19.3% for more than 24 months and 9.7% did not
answer this question. From the 29.8% that did not RTW, 78.4%
declared they wished to return.
Most participants reported they liked their work activity
(64.5%) and received support from employer (56.4%), but
only 33.1% indicated they had been offered work
adjustments after cancer diagnosis. Only 19.3% said that
they had no difficulties in returning to work. The desire to
change their work activity after BC diagnosis was reported
by 65 (52.4%) participants. Among the main reasons for
wanting to change were: the attempt to reduce stress in
the daily routine (n=46; 37.1%), change of priorities (n=38;
30.6%)and the desire to reduce the workload (n=21; 16.9%).
Multivariate analysis of characteristics associated with
being employed after BC diagnosis is described on Table 3.
A limitation of this study is the use of a convenience sample,
thus, the associations found are limited to the participating
women.
RESULTS
Landeiro, L. et al. Cancer. 2018 Dec 15;124(24):4700-4710
Butow P, et al. J Cancer Surviv. 2020 Apr;14(2):114-134
Schmidt ME, et al. Eur J Cancer Care (Engl). 2019 Jul;28(4):e13051
Luciana Landeiro1, Luciana Holtz de Camargo Barros2, Lycia TramujasVasconcellos Neumann2, André Marques
Santos2, Anna Carolina Arena Siqueira2 and Rafael Kaliks2.
1Research Department, Grupo Oncoclínicas, 2Research Department, Instituto Oncoguia
Return to work after breast cancer: disparities among patients treated in public and private hospitals in Brazil.
CONTACT
This presentation is the intellectual property of the author/presenter. Contact them at pesquisa@oncoguia.org.br for permission to reprint and/or distribute.
San Antonio Breast Cancer Symposium - December 7-10, 2021
Abstract #2039 Program # P4-11-17
Correspondence: Luciana Landeiro at
luciana@medicos.oncoclinicas.com
REFERENCES
124 women fulfilled all inclusion criteria and agreed to participate on this
online survey. Table 1 lists the demographic and clinical characteristics of the
participants. Table 2 describes socioeconomic characteristics.
Characteristics n %
Education
High school degree or lower 32 25,8
College degree or higher 92 74,2
Race
White 89 71,8
Black 32 25,8
Did not answer 3 2,4
Area of residence
Northeast 28 22,6
Southeast 84 67,7
Other 12 9,7
Marital status
Partnered/ married 87 70,2
No partner 35 28,2
Did not answer 2 1,6
BC stage
I 15 12,1
II 32 25,8
III 37 29,8
TABLE 1. Demographic and Clinical characteristics (N = 124)
TABLE 2. Socioeconomic characteristics (N = 124)
Characteristics n %
Health care system
Health plan/ private services 102 82,3
Public 22 17,7
Patient as main source of household income
No 57 46,0
Yes 66 53,2
Did not answer 1 0,8
Household income before BC diagnosis*
<4 MW 44 35,5
4-10 MW 48 38,7
>10 MW 32 25,8
Household income changed after BC diagnosis?
Did not change 91 73,4
For less 22 17,7
For more 9 7,3
Did not answer 2 1,6
Responsible for children under 18y
No 81 65,3
Yes 42 33,9
Did not answer 1 0,8
Abbreviation: MW, minimum wage.
*In Brazil, the MW was set to a value of approximately US $196.08 per month.
In North America and Europe return to work (RTW) rates vary among breast
cancer (BC) survivors from 24-66% and 53-82% after 06 and 36 months of
diagnosis respectively. An observational study published in 2018 evaluated
return to work among Brazilian patients treated in one public hospital in São
Paulo, and described RTW rates of 30.3 and 60.4%, after 12 and 24 months of
BC diagnosis, respectively. The aim of the present study was to evaluate RTW
rates among a broader population of Brazilian BC patients, including patients
with metastatic disease and treated in private hospitals, and to describe
factors associated with this outcome.
Characteristics n %
BC stage (continuation)
IV 16 12,9
Unknown 24 19,3
BC treatment
Surgery 121 97,6
Chemotherapy 98 79,0
Endocrine therapy 69 55,7
Radiotherapy 96 77,4
Did you have any other health problem diagnosed
after BC?
No 41 33,1
Yes 83 66,9
Hypertension or Diabetes 16 12,9
Depression 26 21,0
Chronic pain (breast/arm) +-
Lymphedema (arm) 39 31,4
Differences in RTW rates in private versus public hospitals may explain
the better RTW rate found in this study, in contrast with previous study
conducted with Brazilian patients treated in a public hospital in São
Paulo. Ultimately, identifying patients who will likely experience
difficulties to RTW (patients who developed depression after BC and
those not satisfied with their jobs) can hopefully trigger patient
support strategies. All stakeholders in the return to work process after
a cancer diagnosis (organizations, clinicians and government)
should think strategies to better assist patients in their rehabilitation
work process and with possible career transitions.
CONCLUSIONS
This was a cross-sectional study. BC patients included in 2019 were registered
on the portal of the NGO Instituto Oncoguia, one of the largest Brazilian
cancer patient support organization. After an amendment in 2020 patients
that had their oncology care at one of the cancer centers from the
Oncoclínicas group in Bahia, Rio de Janeiro or São Paulo, were also included.
Patients received an email invitation to participate in this study by answering
an online survey (the invitation was sent twice for each patient, in order to
improve recruitment). Inclusion criteria were: BC women diagnosed with
tage I-IV within 12 to 36 months from survey date, age 18-65, with paid work
before BC diagnosis. The Institutional Review Board (IRB) of the Hospital Santo
Antônio/ Obras Sociais Irmã Dulce, in Salvador- Bahia, approved the study.
Characteristics
Unadjusted
OR
CI95%
Ajusted
OR
CI95%
P-
value
Depression after BC diagnosis
No 1 1
Yes 0.39 0.16-0.97 0.13 0.01-0.91 0.040
Health care system
Public 1 1
Health plan/ private
services 4.69 1.78-12.32 13.74 1.76-106.96 0.012
Are you satisfied with your work activity?
No 1 1
Yes 3.65 1.63-8.17 4.69 1.10-19.98 0.036
Time to return to work (in months)
<6 1 1
6-12 0.21 0.02-1.96 0.32 0.02-4.54 0.404
12-24 0.11 0.01-1.01 0.24 0.01-3.03 0.271
>=24 0.01 0.01-0.11 0.02 0.01-0.32 0.004
TABLE 3. Multivariate Analysis of Characteristics Associated With Being Employed
After BC Diagnosis