Health-related quality of life and fear of recurrence after early breast cancer treatment: Results from a cross-sectional survey

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BACKGROUND: The growing population of breast cancer survivors has raised attention to the long-term effects of treatment and follow-up. This study explored how survivors experience follow-up care and its impact on quality of life, focusing on fear of cancer recurrence (FCR), work and financial burden. METHODS: In this monocentric observational study, survivors completed a questionnaire including validated items from GIVIO, EORTC QLQ-C30, and FCR Inventory Short-Form. Fourteen domains were assessed. Scores were scaled 0-100, with higher values indicating better outcomes, except for FCR, where higher scores indicate greater concern. Data were stratified by age, time since diagnosis, education, income. Cluster analysis uncovered patterns of survivor experience across questionnaire domains. RESULTS: Of 1565 women scheduled for follow-up over six months, 681 (43.5 %) agreed to participate and, after excluding patients not fulfilling the protocol, and questionnaires with >50 % missing data, 656 entered the final analysis. Mean quality of life (73.3), physical (75.6), and social functioning (82.7) scored high, while emotional (55.6) and cognitive functioning (61.6) were lower. Satisfaction with care was mixed, with lower ratings for the national health system-level (56.8). FCR was moderate overall (38), with recurrent/intrusive thoughts in 2.9 % and 5.6 % of respondents. Lower income was significantly associated with worse outcomes across several domains, while no relevant differences were observed by age, education, or time since diagnosis. Cluster analysis revealed two distinct response profiles, clearly distinguished only by socioeconomic status. CONCLUSIONS: Breast cancer survivors reported overall good levels of functioning, with lower scores in emotional and cognitive domains. Socioeconomic status was the only factor clearly associated with distinct response patterns.

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