Rory Meyers College of Nursing, New York University Rory Meyers College of Nursing, New York, New York, USA.
School of Nursing, Yale University School of Nursing, Orange, Connecticut, USA.
Psychooncology. 2021 Aug;30(8):1322-1331. doi: 10.1002/pon.5679. Epub 2021 Apr 2.
Fear of cancer recurrence (FCR) is the greatest unmet psychosocial need among breast cancer survivors (BCS). The Oncotype Dx® test predicts the 10-year risk of distant recurrence and benefit of adjuvant chemotherapy among women with early stage hormone receptor-positive breast cancer. Despite the test's clinical utility, psychosocial responses are poorly understood.
A descriptive cross-sectional study was conducted to explore associations between Oncotype Dx® test results (Recurrence Score [RS]) and FCR, health-related quality of life (HRQOL), distress, anxiety, depression, illness representation and perceived risk. Bivariate analyses were used to examine the associations between variables followed by multiple linear regression to examine predictors of FCR.
Greater FCR was associated with higher distress, anxiety, depression, illness representation and poorer HRQOL. BCS's with a high Oncotype Dx® RS reported higher overall fear (p = 0.013) and greater perceived consequences of their cancer (p = 0.034) compared to BCS's with a low RS. Using multiple linear regression, anxiety ( = 0.21, p = 0.016), greater emotional response = 0.45, p < 0.001) and perceived consequences ( = 0.18, p = 0.039) of illness explained 58% of the variance (p < 0.001) in FCR.
BCS's with higher risk of recurrence may experience higher FCR. However, for FCR, modifiable factors such as anxiety and illness representation (greater emotional response and perceived consequences of illness) may be more important than non-modifiable factors such as Oncotype Dx® test results and age. Further research is needed to develop personalized interventions to improve BCS's outcomes.
癌症复发恐惧（FCR）是乳腺癌幸存者（BCS）最大的未满足的心理社会需求。Oncotype Dx® 测试可预测早期激素受体阳性乳腺癌女性的远处复发风险和辅助化疗获益。尽管该测试具有临床实用性，但对其心理社会反应仍知之甚少。
进行了一项描述性横断面研究，以探讨 Oncotype Dx® 测试结果（复发评分 [RS]）与 FCR、健康相关生活质量（HRQOL）、困扰、焦虑、抑郁、疾病认知和感知风险之间的关系。采用双变量分析检查变量之间的关联，然后采用多元线性回归分析检查 FCR 的预测因素。
FCR 较高与较高的困扰、焦虑、抑郁、疾病认知和较差的 HRQOL 相关。Oncotype Dx® RS 较高的 BCS 报告总体恐惧程度更高（p=0.013），对癌症后果的感知更严重（p=0.034），与 RS 较低的 BCS 相比。使用多元线性回归，焦虑（β=0.21，p=0.016）、更大的情绪反应（β=0.45，p<0.001）和疾病的感知后果（β=0.18，p=0.039）解释了 FCR 方差的 58%（p<0.001）。
复发风险较高的 BCS 可能会经历更高的 FCR。然而，对于 FCR，可改变的因素，如焦虑和疾病认知（更大的情绪反应和疾病后果的感知）可能比不可改变的因素，如 Oncotype Dx® 测试结果和年龄更重要。需要进一步研究以开发个性化干预措施来改善 BCS 的结局。
