Arm morbidity and sick leave among working women shortly after breast cancer surgery.
BACKGROUND
There is limited knowledge about the impact of arm morbidity on sick leave in the immediate period after breast cancer surgery.


OBJECTIVE
To determine if arm morbidity was associated with sick leave shortly after breast cancer surgery and to investigate the association between arm morbidity and sick leave, adjusted for treatment, work characteristics, co-morbidity, time since surgery, and sociodemographic factors.


METHODS
Included were 511 women who within 12 weeks had had breast cancer surgery, were aged 20-63 years, had no distant metastasis, pre-surgical chemotherapy, or previous breast cancer, and worked ≥75% before breast cancer diagnosis. Percentages and odds ratios (OR) for being on sick leave were calculated, using multivariable analyses.


RESULTS
Of the women, 10% reported arm morbidity, 43% had had a total axillary clearance, and 60% were on sick leave. In multivariable analysis, those with planned chemotherapy had the highest OR (4.69; 95% CI 2.97-7.41) for being on sick leave. Nevertheless, those reporting arm morbidity had the second highest OR (2.71; 1.23-5.97) which was higher than if having strenuous work postures (2.49; 1.50-4.15) or having had an axillary clearance (1.64; 1.04-2.60).


CONCLUSIONS
Arm morbidity is an important factor for whether being on sick leave or not shortly after breast cancer surgery, even more important than type of axillary surgery or work situation. However, planned chemotherapy had the greatest impact for being on sick leave already shortly after breast cancer surgery.
Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. agneta.wennman-larsen@ki.se
Agneta
A
Wennman-Larsen
Mariann
M
Olsson
Kristina
K
Alexanderson
Marie I
MI
Nilsson
Lena-Marie
LM
Petersson
D000328:Adult; D001132:Arm / Q000503:physiopathology; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000601:surgery*; D015984:Causality; D015897:Comorbidity; D004421:Dystonia / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008209:Lymphedema / Q000453:epidemiology; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D018582:Sick Leave / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D013548:Sweden; D014931:Women, Working / Q000706:statistics & numerical data*; D055815:Young Adult