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Epidemiology

Working conditions associated with return to work 2 years after breast cancer: insights from a cohort study

British Journal of Cancer volume 134, pages 92–98 (2026) Cite this article

Subjects

Abstract

Background

Work-related determinants of return to work (RTW) after breast cancer (BC) have been poorly studied.

Methods

We analysed data from 2095 patients with primary BC enrolled in the French multi-center prospective cohort CANTO between 2012 and 2018. We investigated the association between administrative, physical and psychosocial working conditions and RTW two years after diagnosis using Poisson regression with robust variance. All models were adjusted for age, education, having a partner or children, and clinical variables at diagnosis. Analyses stratified by education (up to/higher than high school) and by chemotherapy were conducted. Multiple imputations were performed.

Results

Having no weekly rest period of 48 consecutive hours (RR = 1.36 95% CI:1.09–1.81), strenuous work postures (RR = 1.48 95% CI:1.19–1.87) and shift work (RR = 1.40 95% CI:1.11–1.75) as well as low independence of decision making (RR = 1.33 95% CI:1.04–1.81) were associated with increased non-RTW. Not perceiving her own job as boring (RR = 0.61 95% CI:0.39–0.86) was associated with decreased non-RTW. Administrative working conditions did not impact RTW.

Conclusion

Working conditions emerged as potential levers to help women RTW. Our results underline the need for more targeted rehabilitation programs and personalized interventions to effectively help women in their RTW journey after BC.

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Fig. 1: Eligibility flow-chart of study population.
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Data availability

CANTO data are not publicly available and can be obtained from UNICANCER. Scripts can be obtained upon reasonable request.

Code availability

CANTO data are not publicly available and can be obtained from UNICANCER. Scripts can be obtained upon reasonable request.

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Funding

The CANTO study is supported by the French Government under the ’Investment for the Future’ program managed by the National Research Agency (ANR), grant no. ANR-10-COHO-0004, Fondation ARC pour la Recherche sur le Cancer (number PGA1 RF20170205420) and INCa (grant SHS-E-SP 2022-138).

Author information

Authors and Affiliations

  1. University Paris Saclay, Gustave Roussy Institute, INSERM, Molecular Predictors and New Targets in Oncology, Villejuif, France

    Garazi Ruiz de Azua, Idlir Licaj, Julie Havas, Antonio Di Meglio, Ines Vaz-Luis, Barbara Pistilli, Fabrice André & Gwenn Menvielle

  2. Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway

    Idlir Licaj

  3. Sorbonne Université, INSERM, Institut Pierre Louis d’Épidémiologie et de Santé Publique, IPLESP, Équipe de Recherche en Épidémiologie Sociale, Paris, France

    Sandrine Pinto

  4. Gustave Roussy, Medical Oncology Department, Villejuif, France

    Antonio Di Meglio, Ines Vaz-Luis, Barbara Pistilli & Fabrice André

  5. UNICANCER, Direction des Data et des Partenariats, Le Kremlin-Bicêtre, France

    Anne-Laure Martin & Sibille Everhard

  6. Institut Godinot, Reims, France

    Christelle Jouannaud

  7. Institut Bergonié, Bordeaux, France

    Marion Fournier

  8. Institut régional du cancer de Montpellier - Val d’Aurelle, Montpellier, France

    Philippe Rouanet

  9. Institut de cancérologie de Lorraine - Alexis Vautrin, Vandoeuvre lès Nancy, France

    Asma Dhaini-Merimeche

  10. Institut de Cancérologie de L’ouest -Site Angers, Angers, France

    Baptiste Sauterey

  11. Institut de Cancérologie de l’Ouest - Site de Nantes, Nantes Saint Herblin, France

    Mario Campone

  12. Institut Paoli-Calmettes, Marseille, France

    Carole Tarpin

  13. Institut CURIE - Site de Saint Cloud, Saint Cloud, France

    Florence Lerebours

  14. INSERM, Aix Marseille Univ, IRD, ISSPAM, SESSTIM (Economic and Social Sciences of Health and Medical Information Processing), CALIPSO team, Marseille, France

    Agnès Dumas

Authors
  1. Garazi Ruiz de Azua
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  2. Idlir Licaj
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  3. Sandrine Pinto
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  4. Julie Havas
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  5. Antonio Di Meglio
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  6. Ines Vaz-Luis
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  7. Barbara Pistilli
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  8. Fabrice André
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  9. Anne-Laure Martin
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  10. Sibille Everhard
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  11. Christelle Jouannaud
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  12. Marion Fournier
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  13. Philippe Rouanet
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  14. Asma Dhaini-Merimeche
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  15. Baptiste Sauterey
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  16. Mario Campone
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  17. Carole Tarpin
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  18. Florence Lerebours
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  19. Agnès Dumas
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  20. Gwenn Menvielle
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Contributions

GM and AD designed the study. SP, JH, and IL prepared the dataset and conducted the analyses. GR, IL, AD, and GM interpreted the results and wrote the original draft. GR, IL, SP, JH, ADM, IVL, BP, FA, ALM, SE, CJ, MF, PR, AD-M, BS, MC, CT, FL, AD, and GM reviewed and edited the manuscript and approved its final version.

Corresponding author

Correspondence to Gwenn Menvielle.

Ethics declarations

Competing interests

IVL: Honoraria: AstraZeneca (Inst), Amgen (Inst), Pfizer (Inst), Novartis (Inst), Sandoz (Inst); Research Funding: Resilience (Inst), Travel: Novartis. BP: Consulting fees: Astra Zeneca (institutional), Seagen (institutional), Gilead (institutional), Novartis (institutional), Lilly (institutional), MSD (institutional), Pierre Fabre (personal), Daiichi-Sankyo (institutional/personal); Research funding (to my institution): Astra Zeneca, Daiichi-Sankyo, Gilead, Seagen, MSD; Travel support: Astra Zeneca; Pierre Fabre; MSD; Daiichi-Sankyo; Pfizer.

Ethics

All methods were performed in accordance with the relevant guidelines and regulations.

Ethics approval and consent to participate

The study was approved by the national regulatory authorities and ethics committee (ID-RCB:2011-A01095-36, 312 11-039). CANcer TOxicities is a trial research involving the humans benefiting from authorization from the French National Agency for the Safety of Medicines and Health Products obtained on 14 September 2011 (number B111158-20) and from the Ile-de-France VII Committee for the Protection of Individuals obtained on 14 October 2011 (number 11-039). Informed consent was obtained from all subjects involved in the study.

Consent for publication

Not relevant. No individual person’s data.

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Ruiz de Azua, G., Licaj, I., Pinto, S. et al. Working conditions associated with return to work 2 years after breast cancer: insights from a cohort study. Br J Cancer 134, 92–98 (2026). https://doi.org/10.1038/s41416-025-03238-4

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