Objectives To investigate the associations between quality of life, co-morbidity, treatment and social support from the workplace with non-employment and early retirement among breast cancer survivors.

Methods We identified breast cancer survivors diagnosed between 1997 and 2002 from a hospital or cancer registry in Denmark, Finland, Iceland and Norway (a NOCWO study). All patients had been treated with curative intent. Information on employment, co-morbidity and support was collected via a questionnaire 1–8 years after diagnosis (response rate 76%). The sample included 1111 working-aged currently cancer-free survivors who had been employed at the time of diagnosis. Multivariable logistic regression models were used to analyse the association of various determinants with early retirement and non-employment (due to unemployment, subsidised employment or being a homemaker).

Results Among the breast cancer survivors, 82% were employed, 11% were retired and 7% were non-employed. Low physical quality of life, co-morbidity and pain were associated with both non-employment and early retirement after cancer. In addition, non-employed survivors rated their mental quality of life lower and had received less support from the supervisor in their workplace after the diagnosis than the employed survivors, whereas retired survivors more often had blue collar occupations and low level of support from co-workers. Chemotherapy was not associated with retirement or non-employment.

Conclusions Lack of supervisors' or colleagues' support seemed to play a role in the breast cancer survivors' non-participation in the workforce. Morbidity, pain and low quality of life were also associated with both early retirement and being non-employed.