乳腺癌 (BC) 治疗后重返工作岗位取决于多种因素，包括与治疗相关的不良反应。虽然 BC 患者经常报告与癌症相关的认知障碍，但迄今为止，还没有纵向研究评估其与重返工作岗位的关系。 为了检查使用客观和主观评分评估的认知是否与 2 年后重返工作岗位相关BC 诊断。在法国癌症毒性 (CANTO) 队列的病例系列中，一项针对 I 至 III 期 BC 患者的研究调查了 2014 年 4 月至 2018 年 12 月（2 年随访）的认知能力。参与者包括 BC 诊断时年龄为 58 岁或以下、已就业或正在寻找工作的女性。结果是在 BC 诊断后 2 年后评估重返工作岗位。在诊断时（基线）、治疗完成后 1 年和诊断后 2 年对客观认知功能（测试）、认知症状、焦虑、抑郁和疲劳进行前瞻性评估。使用多变量逻辑回归模型根据每个认知测量分别解释第 2 年重返工作状态，并根据年龄、职业类别、诊断分期和化疗进行调整。最终样本包括 178 名 BC 女性（中位年龄：48.7 [范围，28-58]岁），其中 37 名（20.8%）在第 2 年没有重返工作岗位。重返工作岗位的患者职业等级较高（即专业），并且不太可能进行乳房切除术（ 24.1% 与 54.1%；P < .001)。第 2 年重返工作岗位与较低的整体认知障碍（1 点单位增加的比值比 [1-pt OR]，0.32；95% CI，0.13-0.79；P = .01）、较高的工作记忆（1 -pt OR，2.06；95% CI，1.23-3.59；P = .008），更高的处理速度（1-pt OR，1.97；95% CI，1.20-3.36；P = .01）和更高的注意力表现（1 - pt OR, 1.63; 95% CI, 1.04-2.64; P = .04)，较高的感知认知能力 (1-pt OR, 1.12; 95% CI, 1.03-1.21; P = .007)，以及较低的抑郁症 (第 2 年评估时，1 点 OR，0.83；95% CI，0.74-0.93；P = .001。第 2 年重返工作岗位与基线和第 1 年评估的多项指标相关：更高的处理速度（1 分 OR，2.38；95% CI，1.37-4.31；P = .003 和 1.95；95% CI，1.14- 3.50；P = .02），更高的执行绩效（1 点 OR，2.61；95% CI，1.28-5.75；P = .01 和 2.88；95% CI，1.36-6.28；P = .006），较低的身体疲劳（10 分 OR，0.81；95% CI，0.69-0.95；P = .009 和 0.84；95% CI，0.71-0.98；P = .02）。在 BC 患者的病例系列研究中，诊断后 2 年重返工作岗位与 BC 治疗前后较高的认知速度表现相关。在返回工作岗位之前应评估认知困难，以提出适当的管理建议。

Return to work after breast cancer (BC) treatment depends on several factors, including treatment-related adverse effects. While cancer-related cognitive impairment is frequently reported by patients with BC, to date, no longitudinal studies have assessed its association with return to work.To examine whether cognition, assessed using objective and subjective scores, was associated with return to work 2 years after BC diagnosis.In a case series of the French Cancer Toxicities (CANTO) cohort, a study of patients with stage I to III BC investigated cognition from April 2014 to December 2018 (2 years' follow-up). Participants included women aged 58 years or younger at BC diagnosis who were employed or looking for a job.The outcome was return to work assessed 2 years after BC diagnosis. Objective cognitive functioning (tests), cognitive symptoms, anxiety, depression, and fatigue were prospectively assessed at diagnosis (baseline), 1 year after treatment completion, and 2 years after diagnosis. Multivariable logistic regression models were used to explain return to work status at year 2 according to each cognitive measure separately, adjusted for age, occupational class, stage at diagnosis, and chemotherapy.The final sample included 178 women with BC (median age: 48.7 [range, 28-58] years), including 37 (20.8%) who did not return to work at year 2. Patients who returned to work had a higher (ie, professional) occupational class and were less likely to have had a mastectomy (24.1% vs 54.1%; P < .001). Return to work at year 2 was associated with lower overall cognitive impairment (1-point unit of increased odds ratio [1-pt OR], 0.32; 95% CI, 0.13-0.79; P = .01), higher working memory (1-pt OR, 2.06; 95% CI, 1.23-3.59; P = .008), higher processing speed (1-pt OR, 1.97; 95% CI, 1.20-3.36; P = .01) and higher attention performance (1-pt OR, 1.63; 95% CI, 1.04-2.64; P = .04), higher perceived cognitive abilities (1-pt OR, 1.12; 95% CI, 1.03-1.21; P = .007), and lower depression (1-pt OR, 0.83; 95% CI, 0.74-0.93; P = .001) at year 2 assessment. Return to work at year 2 was associated with several measures assessed at baseline and year 1: higher processing speed (1-pt OR, 2.38; 95% CI, 1.37-4.31; P = .003 and 1.95; 95% CI, 1.14-3.50; P = .02), higher executive performance (1-pt OR, 2.61; 95% CI, 1.28-5.75; P = .01, and 2.88; 95% CI, 1.36-6.28; P = .006), and lower physical fatigue (10-pt OR, 0.81; 95% CI, 0.69-0.95; P = .009 and 0.84; 95% CI, 0.71-0.98; P = .02).In this case series study of patients with BC, return to work 2 years after diagnosis was associated with higher cognitive speed performance before and after BC treatment. Cognitive difficulties should be assessed before return to work to propose suitable management.