Fear of cancer recurrence among young breast cancer patients: a qualitative study guided by social ecological systems theory.

OBJECTIVE: To explore the experiences and needs related to fear of cancer recurrence among young breast cancer patients from the perspective of Social Ecological Systems Theory. METHODS: A descriptive qualitative study design was employed. From September 1 to November 30, 2025, semi-structured interviews were conducted with 16 young breast cancer patients. Guided by social ecological systems theory (SET) as the theoretical framework, data were analyzed using content analysis. RESULTS: A total of three themes and 10 subthemes were identified: (1) Microsystem (Individual Level): hypervigilance to physical symptoms; treatment-related sequelae and ongoing therapy; and from information seeking to fear; (2) Mesosystem (relational level): guilt and frustration arising from role reversal; communication barriers with family and friends; and ambivalent experiences within peer support networks; and (3) Macrosystem (Societal Level): medical advancement entangled with financial burden; career disruption and uncertainty about future employability; chaotic online health information; and insufficient and emerging psychological support systems. CONCLUSION: Fear of cancer recurrence (FCR) among young breast cancer patients is rooted not only in individual bodily vigilance and cognitive biases but also deeply embedded within broader social structures, including family relationships, peer support networks, healthcare and economic policies, occupational environments, information ecosystems, and sociocultural expectations. Therefore, effective management of FCR should extend beyond individual-level psychological interventions and adopt a comprehensive, multi-level approach that addresses the diverse contextual factors shaping patients' experiences.