Factors influencing fear of cancer recurrence in breast cancer survivors: a multicenter cross-sectional study

PURPOSE: Fear of cancer recurrence (FCR) is a prevalent psychological concern among breast cancer survivors, and identifying influencing factors is crucial for designing effective interventions. We aimed to investigate the relationship of FCR with sociodemographic characteristics, clinical features, physical and psychological symptoms, and social support among survivors of breast cancer. METHODS: A cross-sectional study performed between November 2024, and January 2025. 387 potential participants were screened using convenience sampling. Fear of cancer recurrence, symptoms, and social support were assessed using the FCR Inventory-Short Form (FCRI-SF), the Memorial Symptom Assessment Scale (MSAS), and the Social Support Rating Scale (SSRS), respectively. Factors influencing FCR in survivors of breast cancer were determined using multiple linear regression. RESULTS: The findings revealed that age < 40 years (B = 3.505, p = 0.012), severe medical burden (B = 5.079, p < 0.001), tumor stage III (B = 4.309, p = 0.018), cancer diagnosis time of 6-12 months (B = 2.174, p = 0.014), and chemotherapy (B = 2.077, p = 0.031) were significantly associated with higher FCR. Endocrine therapy was positively associated with FCR scores, although this association did not reach statistical significance (B = 2.300, p = 0.054). Among the psychological factors, worrying (B = 2.213, p < 0.001) and feeling nervous (B = 0.880, p = 0.006) were significantly associated with higher FCR. Among the physical factors, "I do not look like myself" (B = 0.796, p = 0.010) and lack of energy (B = 0.662, p = 0.018) were also significantly associated with higher FCR. CONCLUSIONS: FCR in this population is influenced by age, medical burden, cancer stage, duration of cancer diagnosis, treatment methods, and physical and psychological symptoms. Although social support was not significant in this study, its potential role, as reported in previous literature, warrants further attention.