Abstract PS1-01-28: Navigating a path back to work: a cross-sectional analysis of a multicenter survivorship program

Abstract Introduction: With the growing number of cancer survivors, new challenges are emerging for this population. Among them, returning to work often represents a significant hurdle due to persistent physical and psychological toxicities resulting from both the disease and its treatment. Understanding the factors associated with work reintegration is key to promoting long-term quality of life and socioeconomic stability for breast cancer survivors (BCS). Methods: We analyzed data from breast cancer survivors enrolled in “OC sobre VIVER”, a multicenter survivorship program coordinated by the Oncoclínicas Group (Brazil), one of the few structured survivorship care initiatives in Latin America. Participants were 3-18 months post-active treatment. Structured interviews assessed employment status (work interruption during treatment, and return to work afterward), psychosocial aspects (supportive psychosocial network, self-esteem, emotional distress, anxiety, and depression), and treatment-related toxicities (cognitive deficits, arthralgia, pain, motor limitations, and neuropathy). Data was managed via REDCap. Descriptive and bivariate statistical analyses were performed using GraphPad Prism, version 10. Results: From July 2023-March 2025, 391 women were enrolled with a median age of 50 years (range: 30-86). Among 376 participants with available staging data, 360 (95%) had invasive breast cancer, distributed as follows: stage I (55%), stage II (33%), and stage III (12%). Employment status analysis revealed that 40.9% (158/386) of participants discontinued work during treatment. Among these, 56% (n=88) successfully returned to work, and 28% (n=43) required workplace accommodations to resume employment. Overall, 55% (197/356) were working at the time of data collection. BCS who received chemotherapy (CT) tended to have lower return-to-work rates compared to those who did not (48% vs. 62%, p = 0.093). In contrast, patients treated exclusively with hormonotherapy (HT) had a trend toward higher return-to-work rates compared to those who received both CT and HT (66% vs. 52%, p = 0.144). Similarly, BCS reporting symptoms of depression showed lower return-to-work rates than those without depression (44% vs. 56%, p = 0.117). Significantly lower return-to-work rates were also observed among participants who experienced treatment-related toxicities, including motor limitation (39% vs. 57%, p = 0.016), neuropathy (41% vs. 59%, p = 0.015), arthralgia (43% vs. 66%, p = 0.0004), and cognitive impairment (42% vs. 58%, p = 0.049). No statistically significant associations were found with tumor stage (p = 0.572), type of breast surgery (quadrantectomy vs. unilateral or bilateral mastectomy; p = 0.702), HER2-targeted therapy (p = 0.454), immunotherapy (p = 0.710), pain (p = 0.112), supportive psychosocial network (p = 0.844), emotional distress (p = 0.887), anxiety symptoms (p = 0.507), or low self-esteem (p = 0.202). Conclusion: The return to work after breast cancer treatment remains a significant challenge for many survivors, often contributing to psychosocial distress and financial toxicity. The development of structured survivorship care programs that proactively address physical, cognitive, and psychosocial sequelae is essential to support and facilitate a successful and sustainable return to the workforce. Citation Format: M. Mathias Machado, T. Santana, F. Santos Dumont Sorice, F. Oliveira, C. Chiodi, R. Brant Costa, M. de Azevedo Kalile, C. Pavei, M. Borges Bittencourt, D. Strassburger Nunes, H. Pantoja, T. de Melo Passarini, M. Behrends Pinto, M. Couto, C. Perini, C. Cerqueira Mathias, M. Laloni, M. Cruz Rangel Silva, C. Alves Costa e Silva, L. Landeiro. Navigating a path back to work: a cross-sectional analysis of a multicenter survivorship program abstract. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS1-01-28.