Purpose Women undergoing diagnosis and treatment for breast cancer may face challenges in employment. We investigated the impact of demographic, clinical, workplace, and psychosocial characteristics on loss of employment after a breast cancer diagnosis and treatment. We further describe changes in work status and work environment for cancer survivors who sustain employment. Methods We analyzed responses from a survey of breast cancer survivors from the Sister Study and the Two Sister Study cohorts who reported being employed at the time of their breast cancer diagnosis and who reported employment status (lost vs. sustained employment) at the time of survey administration. Multivariate logistic regression was used to identify the effects of lymphedema, neuropathy, problems with memory or attention, social support, health insurance, and sick leave on lost employment, adjusting for demographic characteristics, cancer stage, treatment, and general health. Results Of the 1675 respondents who reported being employed at the time of diagnosis, 83.5% reported being ‘currently’ employed at the time of the survey. Older age, peripheral neuropathy, lack of sick leave, late stage at diagnosis, a recurrence or a new cancer, problems with memory or attention, and poor general health were significantly associated with lost employment. Conclusions The long-term effects of breast cancer treatment and workplace provisions for leave and accommodation may have a substantial effect on women’s ability to sustain employment. The findings from this study highlight challenges reported by cancer survivors that may inform clinical and occupational interventions to support survivors’ return to work.

目的接受乳腺癌诊断和治疗的女性可能面临就业挑战。我们调查了人口、临床、工作场所和心理社会特征对乳腺癌诊断和治疗后失业的影响。我们进一步描述了维持就业的癌症幸存者的工作状况和工作环境的变化。方法我们分析了姐妹研究和两姐妹研究队列中乳腺癌幸存者的调查结果，这些幸存者在乳腺癌诊断时报告了就业情况，并在调查时报告了就业状况（失业与持续就业）行政。使用多变量逻辑回归来确定淋巴水肿、神经病变、记忆或注意力问题、社会支持、健康保险和病假对失业的影响，并根据人口特征、癌症分期、治疗和一般健康状况进行调整。结果在诊断时自称有工作的 1675 名受访者中，83.5% 的人表示在调查时“目前”有工作。年龄较大、周围神经病变、缺乏病假、诊断晚期、癌症复发或新发癌症、记忆或注意力问题以及总体健康状况不佳与失业显着相关。结论乳腺癌治疗和工作场所休假和住宿规定的长期影响可能对女性维持就业的能力产生重大影响。这项研究的结果强调了癌症幸存者报告的挑战，这些挑战可能为临床和职业干预措施提供信息，以支持幸存者重返工作岗位。