Ethnicity and return to work in breast cancer survivors: An exploratory qualitative study

20532 Background: Employment status after breast cancer is related to treatment recovery and quality of life (QoL). While correlates of return to work (RTW) have been previously identified in primarily Caucasian populations (eg. health status and perception of employer discrimination vs. accommodation), limited data exist regarding RTW and its relationship with QoL in ethnic minority breast cancer survivors (BCSs). Methods: Our aims were to improve our understanding of RTW in ethnically diverse BCSs and to pilot test a modified version of a previously used RTW Questionnaire. We conducted a qualitative study of RTW in BCSs from 6 ethnic groups: African-Americans, African-Caribbeans, Caucasians, Chinese, Filipinas, and Latinas. We used a sampling strategy designed to enrich for ethnic minorities and patients experiencing work problems after diagnosis. We organized ethnically cohesive focus groups of 4–6 BCSs who had completed treatment for stage I-III disease and were employed 3 mos. prior to diagnosis. Focus group discussions were audio- and video-recorded, transcribed, and analyzed for content and themes. Participants also completed the RTW questionnaire and gave written feedback. Results: We interviewed 24 subjects in 6 groups. Participants mentioned fear of gossip and/or pity, lack of schedule flexibility for doctors’ visits, cancer-related discrimination, stress, and unpleasant associations with medical equipment at work. Self-image was important among the Caucasian BCSs, while privacy at work was a common theme among all but the Chinese and Latina BCSs. For some, the entire year after diagnosis was a time of perceived treatment, even if all medical therapy had been completed. Those with a strong family history of breast cancer worked through their treatment and said work helped them cope. Positive aspects of early RTW included feelings of independence and wellness and finding a support system among coworkers. The average time for questionnaire completion and feedback was 25.8 min. Conclusions: Ethnically diverse BCSs experience an array of barriers to RTW, some of which may be influenced by ethnicity and culture. A quantitative study using an ethnically sensitive and translated RTW questionnaire is needed to better understand RTW in BCSs of different ethnicities. No significant financial relationships to disclose.