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Open Access 01-12-2021 | Breast Cancer | Original Article

Individual courses and determinants of fear of cancer recurrence in long-term breast cancer survivors with and without recurrence

Authors: Paula Heidkamp, Clara Breidenbach, Kati Hiltrop, Christoph Kowalski, Anna Enders, Holger Pfaff, Birgitta Weltermann, Franziska Geiser, Nicole Ernstmann

Published in: Supportive Care in Cancer | Issue 12/2021

Abstract

Objective

This study investigated the prevalence, individual courses, and determinants of fear of cancer recurrence (FoR) in long-term breast cancer survivors (BCSs) with and without recurrence.

Methods

A total of 184 breast cancer survivors were surveyed at four measurement time points: during hospitalization (T1), 10 weeks (T2), 40 weeks (T3), and 5–6 years (T4) after hospital discharge. Descriptive statistics, chi-square tests, and logistic regression were performed.

Results

Respondents were females and 57 years old, on average. At T1, T3, and T4, 54.8%, 31.6%, and 29.7% of BCSs, respectively, were classified as having dysfunctional levels of FoR. Dysfunctional FoR decreased from T1 to T3 (χ²(1) = 17.11, p = 0.000; N = 163) and remained stable afterwards. Eight subgroups of individual courses of FoR over time could be described: (1) constant functional FoR; (2) constant dysfunctional FoR; (3) improving from dysfunctional to functional FoR from T1 to T3; (4) improving from dysfunctional to functional FoR from T3 to T4; (5) worsening from functional to dysfunctional FoR from T1 to T3; (6) worsening from functional to dysfunctional FoR from T3 to T4; (7) dysfunctional FoR at T1 and T4, and functional FoR in between; and (8) functional FoR at T1 and T4, and dysfunctional FoR in between. Logistic regression analysis revealed that being divorced/widowed, showing high levels of fatigue, being treated by chemotherapy, and having low confidence in treatment were associated with dysfunctional FoR 5 to 6 years after diagnosis (Nagelkerkes’ Pseudo-R2 = 0.648).

Conclusions

The findings reveal that FoR is a significant issue in long-term BCSs and has the potential to become a persistent psychological strain. We emphasize the need for increased awareness of FoR among BCSs and the need for support programs.

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Title: Individual courses and determinants of fear of cancer recurrence in long-term breast cancer survivors with and without recurrence
Authors: Paula Heidkamp
Clara Breidenbach
Kati Hiltrop
Christoph Kowalski
Anna Enders
Holger Pfaff
Birgitta Weltermann
Franziska Geiser
Nicole Ernstmann
Publication date: 01-12-2021
Publisher: Springer Berlin Heidelberg
Keywords: Breast Cancer
Breast Cancer
Anxiety
Fatigue
Published in: Supportive Care in Cancer / Issue 12/2021
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-021-06329-z

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