Fear of cancer recurrence and quality of life in early breast cancer survivors: association with clinical and sociodemographic characteristics.

INTRODUCTION

Fear of cancer recurrence is one of the most frequent concerns among breast cancer survivors and can significantly affect health-related quality of life. However, it remains insufficiently explored in routine clinical practice. The aim of this study is to describe the frequency of fear of cancer recurrence and quality of life in patients with early breast cancer, to analyze their association with clinical and sociodemographic characteristics. As a complementary descriptive exploration, communication between patients and the healthcare team regarding fear of cancer recurrence was also assessed.

METHODS

Cross-sectional observational study conducted in two public centers. A total of 301 women with stage I-III breast cancer, disease-free and at least 12 months post-treatment, were included. Fear of cancer recurrence was assessed using the Cancer Worry Scale, and quality of life was evaluated using the PROMIS Global 10 questionnaire.

RESULTS

High fear of cancer recurrence was observed in 34.9% of participants, and moderate fear of cancer recurrence in 20.9%. This concern was significantly associated with ≤5 years since diagnosis, age <50 years, education level, chemotherapy, and endocrine therapy. No associations were found with tumor stage, type of breast surgery, axillary surgery, or radiotherapy. Nearly half of the patients had not discussed fear of cancer recurrence with their medical team, mainly because they did not consider it a serious issue or were unaware that it could be addressed during consultations. PROMIS scores showed median values of 37.4 for physical health and 43.5 for mental health. Quality of life did not vary according to clinical characteristics or treatments but was associated with age and education. Patients with higher fear of cancer recurrence consistently showed poorer quality of life across all domains (p < 0.001).

CONCLUSIONS

Fear of cancer recurrence is highly frequent and strongly associated with poorer quality of life, independently of clinical variables. Its identification and management should be systematically integrated into survivorship care for women with breast cancer.