Abstract
BACKGROUND: Fear of cancer recurrence (FCR) is a common psychological disorder among patients with cancer. In patients newly diagnosed with breast cancer, fear and concern 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: This study aims to describe the prevalence and severity of FCR before treatment in patients newly diagnosed with breast cancer and analyze its predictive factors, thereby providing a scientific basis for interventions to reduce such fear. METHODS: A cross-sectional study was conducted among patients newly diagnosed with breast cancer prior to treatment at a specialized oncology hospital in Guangdong Province, China, between February 2023 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 used. 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 patients newly diagnosed with breast cancer were enrolled. Among the participants, 48.3% (n=169) experienced FCR before initiating treatment. The mean total score for FCR was 33.44 (SD 8.00). Age, sleep quality, financial burden, monthly household income per capita, family relationships, self-disclosure, and social support accounted for 33.5% (R²) of the variance in FCR. CONCLUSIONS: FCR prior to treatment is common and relatively severe among patients newly diagnosed with breast cancer. Health care professionals should implement targeted interventions to promote self-disclosure and strengthen social support networks to alleviate FCR, facilitate informed treatment decision-making, and improve patients' psychological readiness for treatment. The findings of this study underscore the urgent need for early identification and management of FCR in patients newly diagnosed with breast cancer. High levels of pretreatment FCR may impair patients' psychological well-being and influence treatment decision-making, potentially leading to suboptimal treatment choices. Health care 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.