Fear of progression and symptom trajectories among women with recurrent breast cancer: A six-month prospective study.

PURPOSE: To examine changes in FOP over six months and identify symptoms associated with FOP in women with recurrent breast cancer.

METHODS

In this six-month prospective study, 95 women with recurrent breast cancer from a medical center in Taiwan completed assessments at baseline, 3 months, and 6 months. FOP was measured using the 12-item Fear of Progression Questionnaire - Short form, and symptom severity was assessed with 13 items from the NCCN Breast Symptom Index. Generalized estimating equations (GEE) were used to identify predictors of FOP over time.

RESULTS

Of 124 eligible women, 95 enrolled (76.6% participation; 8.4% attrition). Clinically relevant FOP ranged from 26.4% to 29.5%. Sleep disturbances, fatigue, and worry were the most prevalent and severe symptoms. GEE models identified worsening worry, lack of energy, treatment side effects, hair loss, pain, nausea, and physical decline as significant longitudinal predictors of FOP. Marital status influenced FOP trajectories, with partnered participants showing greater changes than singles.

CONCLUSIONS

FOP persisted over six months and was strongly associated with physical and psychosocial symptoms, but common or severe symptoms were not always the strongest drivers of change, highlighting worsening worry, which may be a particularly actionable target.