Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Dec;29(12):7647-7657.
doi: 10.1007/s00520-021-06329-z. Epub 2021 Jun 17.

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

Paula Heidkamp  1   2 , Clara Breidenbach  3 , Kati Hiltrop  4   5 , Christoph Kowalski  3 , Anna Enders  6 , Holger Pfaff  7 , Birgitta Weltermann  8 , Franziska Geiser  5   9 , Nicole Ernstmann  4   5
Affiliations

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

Paula Heidkamp et al. Support Care Cancer. 2021 Dec.

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.

Keywords: Anxiety; Breast cancer; Fear of cancer recurrence; Oncology; Relapse; Survivorship.

PubMed Disclaimer

Conflict of interest statement

Clara Breidenbach and Christoph Kowalski are employees of the German Cancer Society.

Figures

Fig. 1
Fig. 1
Flow of participants. Note: The number of respondents composes of participants who consecutively participated in every survey wave and those who participated at least once. Dropouts occurred due to nonresponse, death, or unverifiable addresses
Fig. 2
Fig. 2
Levels of fear of recurrence at T1, T3, and T4. N = 155
Fig. 3
Fig. 3
(a) Individual courses of fear of cancer recurrence from T1 to T4 (n = 155); (b) individual courses of fear of cancer recurrence from T1 to T4 of BCSs without recurrence (n = 122); (c) individual courses of fear of cancer recurrence from T1 to T4 of BCSs with recurrence (n = 32)
See this image and copyright information in PMC

References

    1. Götze H, Taubenheim S, Dietz A, Lordick F, Mehnert A. Comorbid conditions and health-related quality of life in long-term cancer survivors-associations with demographic and medical characteristics. Journal of cancer survivorship research and practice. 2018;12(5):712–720. doi: 10.1007/s11764-018-0708-6. - DOI - PubMed
    1. van Leeuwen M, Husson O, Alberti P, Arraras JI, Chinot OL, Costantini A, et al. Understanding the quality of life (QOL) issues in survivors of cancer: towards the development of an EORTC QOL cancer survivorship questionnaire. Health Qual Life Outcomes. 2018;16(1):114. doi: 10.1186/s12955-018-0920-0. - DOI - PMC - PubMed
    1. Herschbach P, Keller M, Knight L, Brandl T, Huber B, Henrich G, et al. Psychological problems of cancer patients: a cancer distress screening with a cancer-specific questionnaire. Br J Cancer. 2004;91(3):504. doi: 10.1038/sj.bjc.6601986. - DOI - PMC - PubMed
    1. Koch L, Jansen L, Brenner H, Arndt V. Fear of recurrence and disease progression in long-term (≥5 years) cancer survivors-a systematic review of quantitative studies. Psychooncology. 2013;22(1):1–11. doi: 10.1002/pon.3022. - DOI - PubMed
    1. Simard S, Thewes B, Humphris G, Dixon M, Hayden C, Mireskandari S, et al. Fear of cancer recurrence in adult cancer survivors: a systematic review of quantitative studies. J Cancer Surviv. 2013;7(3):300–322. doi: 10.1007/s11764-013-0272-z. - DOI - PubMed