Fear of cancer recurrence before treatment in newly diagnosed breast cancer patients: Identification of predictive factors

Background Fear of cancer recurrence (FCR) is a common psychological disorder among cancer patients. In newly diagnosed breast cancer patients, fear and condition about recurrence often influence treatment decision-making. However, the prevalence of FCR before treatment and its key risk factors—such as age, sleep quality, economic status, self-disclosure, and social support—remain unclear. Objective To describe the prevalence and severity of FCR before treatment in newly diagnosed breast cancer patients and analyze its predicting factors, thereby providing a scientific basis for interventions to reduce such fear. Methods A cross-sectional study was conducted among newly diagnosed breast cancer patients prior to treatment at a specialized oncology hospital in Guangdong Province, China, between February and July 2023. Sociodemographic data were collected, including age, gender, ethnicity, religious belief, education level, and marital status. Clinical data included pathological stage, tumor type, and family history of cancer. The Distress Disclosure Index, the Chinese version of the Medical Social Support Scale, and the short form of the Fear of Progression Questionnaire were utilized. Univariate analyses and bivariate correlations were conducted to explore relationships between variables. Multiple regression analysis was performed to identify predictors of FCR. Results A total of 350 newly diagnosed breast cancer patients were enrolled. Among participants, 48.3% experienced FCR before initiating treatment. The mean total score for FCR was 33.44 ± 8.00. Age, sleep quality, financial burden, monthly household income per capita, family relationships, self-disclosure, and social support accounted for 33.7% ( R² ) of the variance in FCR. Conclusion FCR prior to treatment is common and relatively severe among newly diagnosed breast cancer patients. Healthcare professionals should encourage patients to actively enhance self-disclosure and strengthen their social support networks. These strategies may reduce pre-treatment FCR, thereby facilitating more informed and appropriate treatment decision-making. The findings of this study underscore the urgent need for early identification and management of fear of cancer recurrence (FCR) in newly diagnosed breast cancer patients. High levels of pre-treatment FCR may impair patients' psychological well-being and influence treatment decision-making, potentially leading to suboptimal treatment choices. Healthcare professionals should implement targeted interventions that promote self-disclosure and strengthen social support networks to alleviate FCR. These measures can enhance patients' psychological readiness for treatment, facilitate informed decision-making, and ultimately improve clinical outcomes.