title: Cognitive, psychosocial, somatic and treatment factors predicting return to work after breast cancer treatment.
abstract: BACKGROUND
  Breast cancer (BC) may affect the ability to work. In this study, we want to identify any associations between cognitive, psychosocial, somatic and treatment factors with time to return to work (RTW) among women treated for BC.
  
  
  METHODS
  At eight (baseline) and 11(follow-up) months after BC diagnosis, women who had received adjuvant treatment for early BC at Stockholm South General Hospital completed the Headminder neuropsychological tests to obtain the Cognitive Stability Index (CSI), the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire and its Breast Cancer Module. At both time points, we compared the scores from women who had returned to work with those who had not. We also reviewed the medical certificates of women still on sick leave at 8, 11 and 18 months after diagnosis to determine why they had not returned to work.
  
  
  RESULTS
  At baseline, 29 of 45 enroled women were working and 15 were not (one dropped out after baseline testing). The 14 women still not working 11 months after BC diagnosis had more advanced BC (OR = 3.64, 95% CI 2.01-7.31), lymph-node involvement (OR = 18.80, 95% CI 5.32-90.69) and Her 2-positive tumours (OR = 10.42,95% CI 2.19-65.32) than did working women. None of the scores for the four cognitive domains changed significantly at follow-up in either group. Comments on the medical certificates generally supported these findings. Independently of any adjuvant cancer therapy, overall quality of life improved and most women did RTW 18 months after BC diagnosis.
  
  
  CONCLUSIONS
  Chemotherapy is associated with longer periods of sick leave. Cognitive functions do not predict RTW. Independently of any adjuvant therapy, most women eventually RTW in a few months. The ability to predict RTW after BC treatment should help prepare higher-risk patients for delayed RTW and allow earlier interventions to restore their social relations and quality of life.
authors.affiliation: Karolinska Institute, Department of Oncology-Pathology, Stockholm, Sweden. elham.hedayati@ki.se
authors.forename: Elham
authors.initials: E
authors.lastname: Hedayati
authors.forename: Aina
authors.initials: A
authors.lastname: Johnsson
authors.forename: Hassan
authors.initials: H
authors.lastname: Alinaghizadeh
authors.forename: Anna
authors.initials: A
authors.lastname: Schedin
authors.forename: Håkan
authors.initials: H
authors.lastname: Nyman
authors.forename: Maria
authors.initials: M
authors.lastname: Albertsson
mesh_terms: D000328:Adult; D001007:Anxiety; D001943:Breast Neoplasms / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D003071:Cognition; D003863:Depression; D005260:Female; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life; D062707:Return to Work; D013548:Sweden