Prevalence Of Fear Of Cancer Recurrence In Breast Cancer Survivors: A Plight That Needs More Attention From Healthcare Providers

Abstract

Objective: To assess the prevalence of fear of cancer recurrence among breast cancer survivors and to identify the common factors associated with fear of cancer recurrence.

Study Design: Observational cross-sectional study.

Place and Duration of Study: Oncology Department, Fauji Foundation Hospital, Rawalpindi, from April 2024 to December 2024.

Methodology: A total of 62 breast cancer survivors aged between 20 and 70 years who had completed treatment for stage I–III breast cancer were enrolled using non-probability consecutive sampling. Fear of cancer recurrence was assessed using the Fear of Cancer Recurrence Inventory (FCRI), a validated 42-item questionnaire translated into Urdu following forward and backward translation procedures.

Results: The mean age of participants was 48.7 ± 9.6 years. Overall, 38 (61.3%) breast cancer survivors reported moderate to high levels of fear of cancer recurrence. The mean duration since treatment completion was 18.4 ± 7.2 months. Clinically, stage II disease was most common (48.4%), followed by stage III (35.5%) and stage I (16.1%). Hormone receptor-positive tumours were observed in 54.8% of patients, while 25.8% had triple-negative breast cancer and 19.4% had HER2-positive tumours. Combined treatment with surgery, chemotherapy, and radiotherapy was received by 58.1% of participants, and 66.1% were on hormonal therapy for more than six months. The mean Fear of Cancer Recurrence Inventory score was 68.5 ± 18.2, with 61.3% of survivors reporting moderate to high levels of fear of cancer recurrence. Higher fear levels were significantly associated with younger age (p = 0.041), advanced cancer stage (p = 0.036), aggressive tumor subtypes (p = 0.048), and intensive treatment modalities (p = 0.039).

Conclusion: Fear of cancer recurrence is common among breast cancer survivors and is influenced by several demographic and clinical factors. These findings highlight the importance of incorporating psychological assessment and support into routine survivorship care to improve the overall well-being and quality of life of breast cancer survivors.