Breast cancer survivors at work

INTRODUCTION: Residual symptoms such as fatigue, cognitive limitations, and emotional distress can be experienced by cancer survivors. These symptoms may impact their abilities at work. It is unclear to what degree these symptoms are associated with work in occupationally active breast cancer survivors, the most prevalent cancer survivor group. METHODS: A sample of 100 women working part- or full-time with a history of breast cancer and a noncancer comparison group (n = 103) completed questionnaires related to physical fatigue, depression, anxiety, and cognitive limitations. Demographic variables, job stress, type of job, stage at diagnosis, treatment exposure, and health behaviors were also measured as potential confounders. RESULTS: Four years postdiagnosis breast cancer survivors reported higher levels of age-adjusted work limitations (F = 32.708, P < 0.001). Significant group by fatigue (β = -0.311, 95% CI = -0.545 to -0.076) and group by depression (β = 0.331, 95% CI = 0.024 to 0.638) interactions were observed. Fatigue was more strongly related to work limitations in the cancer survivor group whereas depressive symptoms were more strongly related to limitations at work in the noncancer group. Although fatigue accounted for 22% of the variance in the model, it explained 71% of the contribution of symptom burden to the overall model. CONCLUSIONS: Fatigue was more strongly related to work in the breast cancer survivor group after accounting for many potential confounders. There is a pressing need to better understand and effectively manage fatigue in the workplace in occupationally active breast cancer survivors.