title: Breast Cancer Patients' Fear of Treatment: Results from the Multicenter Longitudinal Study BRENDA II.
abstract: BACKGROUND
  Fear of cancer treatment can become overwhelming. It is important to understand what patients are mainly afraid of and what factors are correlated with intense fear of treatment.
  
  
  METHODS
  Patients with primary breast cancer (n = 761) completed questionnaires about fear of treatment before surgery (t1), and before (t2) and after (t3) adjuvant treatment. Psychological comorbidity was assessed using the Patient Health Questionnaire. Logistic regression identified predictors of intense fear of treatment.
  
  
  RESULTS
  Patients were most afraid of chemotherapy (mean score 3.5), and fear remained high throughout follow-up; fear of radiotherapy and of surgery was lower and decreased over time (from 2.7 to 2.2, p < 0.0001; and from 2.6 to 2.2, p < 0.0001, respectively). Patients with psychological co-morbidity (odds ratios (OR) 1.7-3.0) and those who had heard reports of negative experiences with cancer treatments from others (OR 3.8-16.2) were more likely to have intense fear of all the treatments. Patients with a previous cancer less often expressed fear of surgery (OR 0.6, 95% confidence interval 0.4-1.0).
  
  
  CONCLUSIONS
  Fear of treatment, especially of chemotherapy, is prevalent in many patients with primary breast cancer. Patients with psychological co-morbidity and those who have heard reports of negative experiences with cancer treatment are at higher risk of experiencing intense fear.
authors.affiliation: Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre, Johannes Gutenberg University Mainz, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Singer
authors.affiliation: Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre, Johannes Gutenberg University Mainz, Germany.
authors.forename: Maria
authors.initials: M
authors.lastname: Blettner
authors.affiliation: Department of Gynaecology and Obstetrics, University of Ulm, Germany.
authors.forename: Rolf
authors.initials: R
authors.lastname: Kreienberg
authors.affiliation: Department of Gynaecology and Obstetrics, University of Ulm, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Janni
authors.affiliation: Department of Gynaecology and Obstetrics, University of Würzburg, Germany.
authors.forename: Achim
authors.initials: A
authors.lastname: Wöckel
authors.affiliation: Department of Gynaecology and Obstetrics, Hospital Esslingen, Germany.
authors.forename: Thorsten
authors.initials: T
authors.lastname: Kühn
authors.affiliation: Department of Gynaecology and Obstetrics, Hospital Kempten, Germany.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Felberbaum
authors.affiliation: Department of Gynaecology and Obstetrics, Hospital Memmingen, Germany.
authors.forename: Felix
authors.initials: F
authors.lastname: Flock
authors.affiliation: Department of Gynaecology and Obstetrics, University of Ulm, Germany.
authors.forename: Lukas
authors.initials: L
authors.lastname: Schwentner
keywords: Anxiety; Breast neoplasms; Fear; Oncology; Prospective studies