Introduction Returning to work after breast cancer, is associated with different benefits such financial independence and engaging in a meaningful occupation, but often limited by several difficulties.

Objectives To assess the return to work among active Tunisian women after breast cancer and to identify its determinants and barriers.

Methods Women treated for breast cancer, in one of the biggest Tunisian gynecology centers, at least two years and at most five years before the cross-sectional survey onset, and under a regular employment contract at diagnosis time, were included (n=112). Socio-demographic and medical characteristics were collected from medical files. Return to work and its circumstances were investigated during a face-to-face interview.

Results At diagnosis, 26% of patients were under 41 years old (mean age=48±11 years). Patients worked in the public sector in 87% of cases, in a middle or senior management position in 35% and in a limited-term employment contract by 4% of cases. After cancer, 97% of women needed a sick leave (mean duration=9.5 ± 2.5 months). Sick leave was significantly prolonged among patients working in the public sector (p = 0.01), blue collar officiers (p=0.01), unlimited employment contract (p=0.02) and surgical treatment (p=0.01). At investigation time, return to work was noted among 72% of patients, with regain of initial occupied workstation only in 5% of cases. After returning to work, 76% of patients reported incomes decrease and 49% of them co-workers discrimination. Hostility at work motivated 3% of patient to ask for early retirement. Return to work was significantly higher among married women (p=0.02), blue-collar officers category (p=0.01), in case of early diagnosis cancer stage and better health auto assessment (p=0.01).

Conclusion Return to work, an important step in the recovery of a normal life, should be better prepared through a reinforced collaboration between occupational and attending physicians.