A photo elicitation study of fear of cancer recurrence and support needs among breast cancer survivors

Fear of cancer recurrence (FCR) is one of the most common psychological challenges faced by breast cancer survivors. However, limited qualitative research has examined survivors' lived experiences, personal interpretations, and support needs related to FCR. This study aimed to explore the experiences, perceptions, and support needs of breast cancer survivors and to identify existing gaps and preferences in the available support systems. A qualitative photo-elicitation study was conducted between January and March 2025 with 15 breast cancer survivors at two large tertiary hospitals in Beijing, China. Participants submitted 76 photographs, and thematic analysis of the photographs and interviews identified six themes: experiencing and understanding fear of cancer recurrence; experiencing and understanding co-occurring symptoms; impact of co-occurring symptoms; coping strategies for fear of cancer recurrence and co-occurring symptoms; advice to fellow patients for coping with fear of cancer recurrence; and suggestions to healthcare workers for improved support and communication. The themes reflected symptom-related triggers, coping practices including physical activity, and needs for information, peer, and healthcare support. These findings highlight the need for routine screening for fear of cancer recurrence and associated co-occurring symptoms, as well as the provision of clear informational support and psychoeducation. They also suggest the importance of integrating psychological, rehabilitative, and peer-related support into survivorship care. Based on these findings, a conceptual framework was developed to inform future survivorship care and support strategies for breast cancer survivors.