Prospective cohort study of psychological distress trajectories and associated factors in patients with breast cancer

Breast cancer patients often experience significant psychological distress. A prospective cohort study at Wuhan University (China) examined distress trajectories from diagnosis to 6 months post-treatment. The study included 528 breast cancer patients between 1 December 2023 and 31 december 2024. Assessments were made at baseline (diagnosis, T0), after the first treatment (T1), mid-treatment (T2), at treatment completion (T3), at three months post-treatment (T4), and at six months post-treatment (T5). Growth mixture modeling (GMM) was used to identify distinct trajectories of psychological distress. Psychological distress generally decreased over time.Three psychological distress trajectories were identified: a high-distress remission group (17.1%), a moderate-stable distress group (11.9%), and a low-fluctuating distress group (71.0%). Multivariable analyses showed that higher educational attainment, breast-conserving surgery, early disease stage, partial self-management ability, and strong social support were associated with being in the moderate-stable or low-fluctuating groups (p<0.05). Emplyment, health insurance coverage, avoidant medical coping style, and higher baseline anxiety and depression scores were concurrently associated with being in the high-distress remission group (p<0.05). The authors conclude that a substantial proportion of patients showed psychological distress trajectories requiring continuous monitoring and early psychological support.