# Return to work and cancer survivorship needs of breast cancer survivors: an observational prospective single-cohort study in Italy

## TL;DR

This study explores factors affecting return to work and needs of breast cancer survivors in Italy, highlighting key determinants that could help support employment and address survivorship needs.

## Contribution

The study identifies specific factors influencing return to work and unmet needs among breast cancer survivors, offering insights for early intervention.

## Key findings

- Having children, undergoing lymph node dissection, and physically demanding jobs are associated with reduced return to work.
- Severe anxiety and sleep quality are linked to higher unmet needs among breast cancer survivors.
- Early identification of these factors may help mitigate adverse work outcomes and address survivorship needs.

## Abstract

Because work participation is an important goal of individuals with breast cancer (BC), we aimed to investigate the factors that may influence return to work in employed individuals as well as cancer survivorship needs regardless of employment status. Adult individuals with BC were followed up for 12 months after surgery. The impact of patient characteristics on return to work and needs was explored using penalized generalized linear mixed models. Of the 111 participants, 85 were working age and employed. Having children (odds ratio (OR) 0.81), undergoing lymph node dissection (OR 0.66), having targeted therapy (OR 0.78), and having a physically demanding job (OR 0.64) and a more severe disability of the upper limbs (OR 0.98) seemed to be associated with reduced return to work, as did taking sick days between diagnosis and surgery (OR 0.74) and taking sick leave after surgery (OR 13.78). More severe anxiety (OR 0.66), reduced sleep quality (OR 0.40), and upper limb disability (OR 0.13) seemed associated with higher needs. These findings suggest that employment is shaped by key determinants, whose early identification may help mitigate adverse work outcomes and support the timely addressing of needs.

The online version contains supplementary material available at 10.1038/s41598-026-45780-y.