Impact of clinical and treatment characteristics on fear of cancer recurrence and quality of life in survivors of early-stage breast cancer.

Abstract

e12684 Background: Fear of cancer recurrence (FCR) is one of the most frequent concerns among breast cancer survivors and can significantly affect health-related quality of life (HRQoL). However, it remains insufficiently explored in routine clinical practice. Objective: To describe the prevalence of FCR and HRQoL in patients with early breast cancer and to analyze their association with clinical and sociodemographic characteristics. Methods: An ambispective observational study was 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. FCR was assessed using the Cancer Worry Scale, and HRQoL using the PROMIS Global-10 instrument. Results: High FCR was observed in 34.9% of participants, and moderate FCR in 20.9%. FCR was significantly associated with ≤5 years since diagnosis, age <50 years, education level, chemotherapy, and endocrine therapy. No associations were found with tumor stage, breast surgery type, axillary surgery, or radiotherapy. Nearly half of the patients had not discussed FCR 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. HRQoL did not vary according to clinical characteristics or treatments but was associated with age and education. Patients with higher FCR consistently showed poorer HRQoL across all domains (p < 0.001). Conclusions: FCR is highly prevalent and strongly associated with poorer HRQoL, independently of clinical variables. Its identification and management should be systematically integrated into survivorship care for women with breast cancer.