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Adult individuals with BC were followed up for 12 months after surgery. The impact of patient characteristics on return to work and needs was explored using penalized generalized linear mixed models. Of the 111 participants, 85 were working age and employed. Having children (odds ratio (OR) 0.81), undergoing lymph node dissection (OR 0.66), having targeted therapy (OR 0.78), and having a physically demanding job (OR 0.64) and a more severe disability of the upper limbs (OR 0.98) seemed to be associated with reduced return to work, as did taking sick days between diagnosis and surgery (OR 0.74) and taking sick leave after surgery (OR 13.78). More severe anxiety (OR 0.66), reduced sleep quality (OR 0.40), and upper limb disability (OR 0.13) seemed associated with higher needs. These findings suggest that employment is shaped by key determinants, whose early identification may help mitigate adverse work outcomes and support the timely addressing of needs.<\/jats:p>","DOI":"10.1038\/s41598-026-45780-y","type":"journal-article","created":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T23:23:03Z","timestamp":1774567383000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Return to work and cancer survivorship needs of breast cancer survivors: an observational prospective single-cohort study in Italy"],"prefix":"10.1038","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6337-5262","authenticated-orcid":false,"given":"Sara","family":"Paltrinieri","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Braglia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Bravi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Fugazzaro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Costi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,27]]},"reference":[{"key":"45780_CR1","doi-asserted-by":"publisher","first-page":"480","DOI":"10.1007\/s10926-020-09877-z","volume":"30","author":"I Berger","year":"2020","unstructured":"Berger, I., Beck, L., Jones, J., MacEachen, E. & Kirsh, B. 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