Factors affecting the fear of recurrence in Breast cancer patients

The fear of cancer recurrence is defined as a mental state of anxiety or concern that cancer may return or spread. It is assumed to be the commonest unpleasant psychological disorder among cancer survivors. Breast cancer is assumed to be one of the commonest cancers in women. Also, the treatment modalities for breast cancer are strongly developed and there is an increase in the cure rate in recent years. However, surviving cancer patients are still feared of recurrence of the neoplasm. The fear of cancer recurrence affected negatively the patients' health and lowered their quality of life. Therefore, we sought to establish effective preventive strategies to improve the psychological health of patients. We searched the literature and reviewed the most recent available data from 2017 to 2023 to clarify the different factors affecting the fear of cancer recurrence in breast cancer patients.We identified different factors that increase the fear of cancer recurrence in breast cancer patients including; anxiety, chemotherapy, avoidance, intrusive thoughts, distress and exhaustion. Also, we identified other factors that decrease the fear of cancer recurrence in breast cancer patients including; younger age patients, having a good quality of time, good social support and good self-efficacy. Regarding preventive measures; our meta-analysis showed that breast cancer patients who underwent Mindfulness-Based Stress Reduction had significant improvements on the Center for Epidemiological Studies-Depression scale (P<0.0001), State-Trait Anxiety Inventory scale (P=0.0002) and perceived stress scale (P=0.0004). Also, we noticed that breast cancer patients who underwent blended cognitive behavior therapy or Smartphone problem-solving therapy had lower fear of cancer recurrence than those who received usual care. Finally, we advocate more research articles applying different modalities to overcome FCR in patients with breast cancer. Also, we recommend the use of different psychological treatments for patients with breast cancer to decrease their fear of cancer recurrence and improve their health.