Objective: To examine the time course and predictors of fear of cancer recurrence (FCR) in breast cancer survivors over a period of 18 months after initial surgery.Methods: Breast cancer patients (n = 267) were followed until 18 months after primary breast surgery. Shortly after surgery, participants completed the Life Orientation Test-Revised to measure optimism and the Concerns about Recurrence Scale to measure FCR. Mixed regression analysis was performed with age, optimism, marital status, education, type of surgery, with or without lymphectomy, chemotherapy, hormonal therapy, or radiotherapy, time since surgery, and all interactions with time as predictors of FCR.Results: The final model included a significant interaction between age and time since surgery and a main effect for optimism.
Conclusion:These results suggest that the course of FCR depends on the age of breast cancer survivors. Younger survivors showed an increase of fear during the first 1.5 years after breast surgery, whereas older survivors showed stable levels during the first 6 months after which it declined. Also, less optimistic survivors reported higher levels of FCR. Health care providers should pay (extra) attention to FCR in younger and less optimistic patients and offer psychological help when needed. cancer survivors suggest stable levels of fear over time. 2,3,8,9 Longitudinal studies, on the other hand, mostly suggest that the highest levels of FCR are reported immediately after diagnosis and during treatment, which is followed by a decrease after treatment and reaching stability after a few months in breast 12-15 and other types of cancer survivors. 4,11,16 However, some studies report stable levels throughout the entire follow-up period in breast cancer survivors. [17][18][19] Not only the course of FCR but also its association with patientand treatment-related characteristics have been examined. Systematic reviews indicate that the most consistent factors contributing to elevated levels of FCR are younger age, experiencing physical symptoms, and low levels of optimism. 5,7,20 The evidence for the contribution of cancer-related factors (cancer type and stage), treatment-related factors (type of surgery and chemotherapy), sociodemographic factors other than age (sex and education), and