Returning to work after breast cancer diagnosis: a cross-sectional study of socioeconomic and clinical factors associated with return to work in Luxembourg

BACKGROUND: Breast cancer (BC) is one of the most common cancers affecting women globally, with consequences for health, quality of life, and socioeconomic status. Return-to-work (RTW) represents an important milestone for women affected by BC. This study analyses clinical, sociodemographic and socioeconomic factors associated with RTW among women in Luxembourg after BC diagnosis, aiming to identify factors associated with RTW outcomes.

METHODS: This study, conducted under the RELIANCE project, involved an observational, cross-sectional, questionnaire-based pilot study addressing RTW among women diagnosed with BC. Eligible participants were women diagnosed with BC between 2013 and 2018, aged < 65 years at diagnosis, employed in Luxembourg at that time and who had undergone an examination at Service de santé au travail multisectoriel. Of 452 invited women, 164 (39% response rate) completed the questionnaire. Descriptive and multivariable analyses were conducted to assess associations between clinical, socio-demographic and socioeconomic characteristics and RTW outcomes.

RESULTS: Overall, 83% of participants returned to work after BC. Advanced higher education was independently associated with higher odds of RTW (OR = 44.0; 95% CI: 1.52–1272.0; p  = 0.028), while higher education showed a borderline association (OR = 6.07; 95% CI: 0.96–38.4; p  = 0.055). Experiencing premature menopause was also associated with increased odds of RTW (OR = 8.54; 95% CI: 1.58–46.1; p  = 0.013). Absence of comorbidities before BC was associated with higher RTW ( p  = 0.032). Job satisfaction improved after BC (median 7 to 8), while perceived work ability declined (median 9 to 7). In the multivariable linear model, work ability before BC was significantly associated with higher job satisfaction after BC (coefficient = 0.28; 95% CI: 0.02–0.54; p  = 0.036), and job satisfaction before BC showed a positive but non-significant association.

CONCLUSION: Socioeconomic factors, particularly educational attainment, and clinical factors such as premature menopause were independently associated with RTW outcomes among women affected by BC in Luxembourg. Job satisfaction after BC was influenced by women’s work ability before BC, with workplace social support contributing to a lesser extent. Targeted interventions addressing educational disparities, along with workplace support initiatives, are essential to improving RTW outcomes in this population. Longitudinal studies are needed to explore these associations further and identify potential intervention points.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12905-025-04230-z.