Background: Paid work is one of the most important aspects in life among working-aged women diagnosed withbreast cancer. Despite several attempts, no previous study provides a comprehensive overview from the women’s perspective about factors of importance for being able to work or not. Therefore, the aim of this study was to gainknowledge about factors that women themselves state are of decisive importance for being able to work or not during the frst two years after breast cancer surgery.

Methods: Data was collected in a two-year follow-up questionnaire within the frame of a prospective cohort studyof working-aged women who had undergone breast cancer surgery. 749 were included in the questionnaire studyand of the 616 (82%) responding women, 462 (75%) wrote statements on an open-ended question about factors ofdecisive importance for being able to work or not work during the past two years. The statements were analyzed withcontent analysis.

Results: Five categories of factors of importance for being able to work or not were identifed, each covering severalsub-categories: Health and wellbeing, Contacts and encounters, Flexibility and adjustment possibilities, Socioeconomic consequences from working/not working, and Own motivation and characteristics. A wide variety of factorswere mentioned by the women and the fndings give a multifaceted picture of many single but interrelated factors ofdecisive importance for being able to work/not work. The importance of fexibility in the return-to-work process wasstressed, as well as the importance of supportive encounters from, e.g., colleagues, managers, as well as relatives.

Conclusions: The results give a comprehensive overview over a variety of diferent types of factors for being ableto return to/remain in work or to not work after breast cancer surgery, adding new knowledge about e.g. the importance of colleagues, and the women’s own preferences or characteristics. These are factors that diferent stakeholders, both from healthcare but also from the work place and the insurance ofce, need to be aware of and collaboratearound to support women with breast cancer during the period of treatment, rehabilitation and return to work.