Fear of Cancer Recurrence in Young Breast Cancer Survivors: Impact on Surveillance Behaviors.

Abstract

Abstract Introduction: Fear of recurrence (FOR) has been studied in various populations of patients with cancer e.g. colon, prostate, and breast. Breast cancer survivors are often faced with the lingering fear that the cancer may reoccur. It is estimated over 232,000 women diagnosed with breast cancer in 2014 FOR has the possibility to impact the lives of thousands of women. Yet, little is known about FOR in women diagnosed with breast cancer at a young age and are young breast cancer survivors (YBCS). These cancer survivors need additional support, as the probability they will develop another cancer is high. Purpose: The purposes of this study were to 1) describe FOR in a large, statewide sample of YBCS 2) to explore predictors of FOR and 3) to determine if FOR is a mediator for breast cancer surveillance, namely mammograms and clinical breast exams (CBE). Methods: This secondary data analysis examines baseline data collected for an efficacy trial, aiming to increase breast cancer surveillance and use of cancer genetic services among YBCS and their high risk family members. Fear of recurrence was examined in 863 YBCS identified and recruited through the Michigan cancer registry. Participants completed a survey including instruments that measured FOR, quality of life (mental and physical), self-efficacy in managing breast cancer, perceived breast cancer risk, knowledge of breast cancer risk factors, family support, and current breast cancer surveillance practices. Findings: Results of this study suggest predictors of FOR in young breast cancer survivors include African American race, lower level of education, belief that cancer development is by chance, and increased level of anxiety. The strongest predictor of FOR was low level of self-efficacy in managing breast cancer. Being negative for the BRCA1 genetic marker was found not to be associated with FOR in this population. FOR did not mediate surveillance mammograms or clinical breast exams.