Abstract
Background/Objectives: This study aimed to analyze the relationship between emotional functioning and health status in long-term breast cancer survivors (LTBCSs). Additionally, it sought to identify factors that could influence emotional functioning in this population at least five years after cancer diagnosis. Methods: This cross-sectional observational study included 80 LTBCSs, classified into the following two groups, according to their emotional functioning: those experiencing psychological distress (≤90) and those with satisfactory psychological well-being (≥91). The study examined various factors at least five years post-diagnosis, including sociodemographic and clinical characteristics, health-related quality of life (HRQoL), mood state, self-perceived physical fitness, physical activity (PA) level, pain, and cancer-related fatigue (CRF). ANOVA, Mann-Whitney U, and Chi-square tests were conducted, along with correlation and multiple regression analysis. Effect sizes were calculated using Cohen's d. Results: Among the 80 LTBCSs, 47.50% reported psychological distress, while 52.50% maintained satisfactory psychological well-being. Participants in the psychological distress group exhibited significantly poorer HRQoL, lower mood, and reduced self-perceived physical fitness, as well as higher levels of physical inactivity, pain, and CRF (p < 0.05). Regression analysis revealed that "role functioning" (β = 0.59; p < 0.01), "cognitive functioning" (β = 0.26; p < 0.01), "self-perceived physical fitness" (β = 0.20; p = 0.02), and "sadness-depression" (β = 0.18; p = 0.04) were significant predictors of emotional functioning (r(2) adjusted = 0.642). Conclusions: These results emphasize the association between emotional functioning and health status in LTBCSs. Role functioning, cognitive functioning, self-perceived physical fitness, and mood state were identified as relevant factors influencing emotional well-being in this population. Considering these relationships, integrating psychological and physical assessments into survivorship care could support the early detection of at-risk individuals. This approach could also guide interventions to improve their long-term well-being and HRQoL.