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. 2025 Mar 27:16:1521555.
doi: 10.3389/fpsyt.2025.1521555. eCollection 2025.

Association between fear of cancer recurrence and emotional distress in breast cancer: a latent profile and moderation analysis

Yingting Jiang  1 , Hongman Li  1 , Ying Xiong  1 , Xiaoting Zheng  1 , Yanjun Liu  2 , Jian Zhou  2 , Zengjie Ye  3
Affiliations

Association between fear of cancer recurrence and emotional distress in breast cancer: a latent profile and moderation analysis

Yingting Jiang et al. Front Psychiatry. .

Abstract

Background: Breast cancer patients often experience significant psychological challenges, particularly fear of cancer recurrence (FCR), which is a prevalent and distressing concern following diagnosis. FCR can lead to heightened emotional distress, including anxiety and depression. Resilience, the ability to adapt positively to adversity, may play a crucial role in mitigating these negative emotional outcomes. This study aims to explore the heterogeneity of FCR among breast cancer patients and examine the moderating effect of resilience on the relationship between FCR and emotional distress.

Materials and methods: A cohort of 398 breast cancer patients participated in the Be Resilient to Breast Cancer (BRBC) program between May and December 2023. Surveys were administered to assess FCR, resilience, and emotional distress levels. Data were analyzed using two approaches: latent profile analysis (LPA) to identify distinct FCR profiles and moderation analysis to evaluate the role of resilience.

Results: Three distinct FCR profiles were identified: low (27.5%), middle (53%), and high (19.5%). Resilience significantly moderated the association between FCR and anxiety (B = 0.115, SE = 0.046, P = 0.014), but no significant moderating effect was observed for depression.

Discussion: The findings highlight significant heterogeneity in FCR among breast cancer patients, with a substantial proportion experiencing moderate to high levels of FCR. Resilience was found to buffer the impact of FCR on anxiety, suggesting that interventions aimed at enhancing resilience could alleviate anxiety related to FCR in this population. These results underscore the importance of incorporating resilience-focused strategies into psychological therapies for breast cancer patients.

Keywords: emotional distress; fear of cancer recurrence; latent profile analysis; moderation analysis; resilience.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

Figures

Figure 1
Figure 1
The hypothesized model.
Figure 2
Figure 2
Pearson correlation heatmap among fear of cancer recurrence, resilience, and emotional distress. (1) F, Fear of cancer recurrence; R, Resilience; HADS-A, Anxiety subscale; HADS-D, Depression subscale. (2) Significant levels are shown at the top right of the figure, ***<0.001, **<0.01, *<0.05.
Figure 3
Figure 3
Latent profile analysis models and logistic regression results. (a) Fitting index and group size of LPA models; (b) Parameters for the final 3-class; (c) logistic regression results based on LPA. Bold values emphasize the selection of the best profile, or indicate statistically significant results (P<0.05).
Figure 4
Figure 4
ANOVA comparison of HADS scores across LPA-based groups and post-hoc comparison by Bayesian factor analysis. (a) LPA-based differences in HADS scores were estimated by Baysian Factor. (b) ANOVA model averaged posterior distribution. (c) Inferential plots for Bayesian factor analysis.
Figure 5
Figure 5
The moderating effect of resilience between LPA-based FCR and emotional distress. (a) Moderating role of resilience in the association between FCR and anxiety and depression. (b) Plot of interaction between FCR and resilience on anxiety.
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