Association between the fear of cancer recurrence and Traditional Chinese Medicine constitution in breast cancer patients: a cross-sectional study

doi:10.19852/j.cnki.jtcm.2026.03.011

Abstract

Abstract:

OBJECTIVE: To investigate the association between Traditional Chinese Medicine (TCM) constitution and fear of cancer recurrence (FCR) in breast cancer survivors.

METHODS: A cross-sectional study was conducted among breast cancer patients at Guang’anmen Hospital of the Chinese Academy of Traditional Chinese Medicine, China, during the period from April 9, 2023, to July 2, 2024. Data were collected on participants’ common sociodemographic characteristics, medical history, scores on the Fear of Cancer Recurrence Inventory (FCRI), and TCM constitution classification. Statistical analyses employed independent samples t-test, χ ² test, Fisher’s exact test, one-way analysis of variance, Spearman’s correlation coefficient, multiple linear regression analysis, and multivariate logistic regression analysis.

RESULTS: A total of 279 eligible breast cancer patients enrolled in this study. The most prevalent TCM constitutions were ‘Qi-depression’, ‘Peaceful’ and ‘Yang-deficiency’. All nine TCM constitutions of breast cancer patients exhibited significant correlations with FCR scores. The strongest positive correlation was observed between ‘Qi-stagnation’ and FCR (r= 0.5576, P < 0.0001), followed by ‘Qi-deficiency’ (r = 0.4465, P < 0.0001). By contrast, the Peaceful correlation showed a significant negative correlation with FCR (r = －0.363, P < 0.0001). Multiple linear regression analysis showed that TCM constitution, lymph node metastasis, and endocrine therapy were influencing factors for FCR in breast cancer patients (P < 0.05). Additionally, multivariate logistic regression analysis was performed to identify factors associated with TCM constitution in breast cancer patients. After adjusting for potential confounding factors including age, disease stage, pathological type, immunohistochemical status, lymph node metastasis, disease duration, and treatment modality, FCR, disease stage, age, and surgical modality were found to be significantly associated with TCM constitution (all P < 0.05).

CONCLUSION: This study demonstrates a significant association between TCM constitution and FCR in breast cancer patients, suggesting that FCR can potentially be interpreted within the theoretical framework of TCM. These findings thus provide a theoretical foundation for TCMC-informed management strategies targeting FCR in breast cancer patients.

Key words: breast neoplasms, Traditional Chinese Medicine constitution, fear of cancer recurrence, cross-sectional studies

WANG Runxi, FANG Liyuan, WANG Yan, XIE Yi, FANG Yuhang, SUI Bailu, YUAN Xinhe, CHEN Yu, ZHANG Ying. Association between the fear of cancer recurrence and Traditional Chinese Medicine constitution in breast cancer patients: a cross-sectional study[J]. Journal of Traditional Chinese Medicine, 2026, 46(3): 715-725.

Figures/Tables 5

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	Crude model		Model Ⅰ		Model Ⅱ
Item	OR (95% CI)	P value	OR (95% CI)	P value	OR (95% CI)	P value
Peaceful	0.991 (0.973, 1.011)	0.380	0.994 (0.974, 1.015)	0.578	0.995 (0.973.1.018)	0.668
Qi-deficiency	0.998 (0.944, 1.054)	0.934	0.861 (0.637, 1.162)	0.327	0.991 (0.957, 1.026)	0.612
Yang-deficiency	1.022 (1.004, 1.041)	0.017	1.026 (1.006, 1.047)	0.010	1.026 (1.004, 1.049)	0.021
Yin-deficiency	0.976 (0.947, 1.007)	0.126	0.972 (0.935, 1.010)	0.149	0.963 (0.915, 1.013)	0.145
Phlegm-dampness	1.023 (1.005, 1.041)	0.012	1.025 (1.006, 1.045)	0.012	1.028 (1.006, 1.051)	0.013
Dampness-heat	0.998 (0.978, 1.018)	0.832	1.000 (0.979, 1.022)	0.985	1.002 (0.978, 1.027)	0.871
Blood-stasis	0.978 (0.96, 0.995)	0.012	0.975 (0.957, 0.994)	0.012	0.972 (0.951, 0.994)	0.013
Qi-depression	0.993 (0.974, 1.013)	0.479	0.995 (0.974, 1.016)	0.639	0.995 (0.972, 1.018)	0.671
Special diathesis	0.995 (0.972, 1.018)	0.642	0.995 (0.971, 1.019)	0.659	1.001 (0.975, 1.029)	0.925

	Crude model		Model Ⅰ		Model Ⅱ
Item	OR (95% CI)	P value	OR (95% CI)	P value	OR (95% CI)	P value
Peaceful	0.991 (0.973, 1.011)	0.380	0.994 (0.974, 1.015)	0.578	0.995 (0.973.1.018)	0.668
Qi-deficiency	0.998 (0.944, 1.054)	0.934	0.861 (0.637, 1.162)	0.327	0.991 (0.957, 1.026)	0.612
Yang-deficiency	1.022 (1.004, 1.041)	0.017	1.026 (1.006, 1.047)	0.010	1.026 (1.004, 1.049)	0.021
Yin-deficiency	0.976 (0.947, 1.007)	0.126	0.972 (0.935, 1.010)	0.149	0.963 (0.915, 1.013)	0.145
Phlegm-dampness	1.023 (1.005, 1.041)	0.012	1.025 (1.006, 1.045)	0.012	1.028 (1.006, 1.051)	0.013
Dampness-heat	0.998 (0.978, 1.018)	0.832	1.000 (0.979, 1.022)	0.985	1.002 (0.978, 1.027)	0.871
Blood-stasis	0.978 (0.96, 0.995)	0.012	0.975 (0.957, 0.994)	0.012	0.972 (0.951, 0.994)	0.013
Qi-depression	0.993 (0.974, 1.013)	0.479	0.995 (0.974, 1.016)	0.639	0.995 (0.972, 1.018)	0.671
Special diathesis	0.995 (0.972, 1.018)	0.642	0.995 (0.971, 1.019)	0.659	1.001 (0.975, 1.029)	0.925

Model	Unstandardized coefficients		Standardized coefficients	t	Sig.	95% CI for B
Model	B	Std. error	Beta	t	Sig.	Lower bound	Upper bound
Constant	63.984	29.416	-	2.175	0.032	5.586	122.383
TCM constitutions	2.892	1.022	0.264	2.830	0.006	0.864	4.921
Age	0.042	0.298	0.016	－0.139	0.890	0.633	0.550
Pathological type	3.474	3.081	0.110	1.128	0.262	－2.643	9.591
Tumour Stages	6.720	5.008	0.157	1.342	0.183	－3.223	16.663
ER+	－33.908	23.056	0.150	－1.471	0.145	－79.679	11.863
PR+	2.315	10.842	0.022	0.214	0.831	－19.209	23.839
Ki-67	－5.220	5.169	0.099	－1.010	0.315	－15.482	5.043
lymphatic node transfern	－23.203	7.279	0.380	－3.188	0.002	－37.653	－8.754
Time of illness	2.115	1.094	0.197	1.934	0.056	0.056	4.287
Treatment programme	1.458	1.459	0.105	1.000	0.320	－1.438	4.354
Endocrine therapy	4.164	2.089	0.206	1.993	0.049	0.017	8.311
Surgical procedure	－1.112	6.411	0.018	0.173	0.863	－13.840	11.616

Model	Unstandardized coefficients		Standardized coefficients	t	Sig.	95% CI for B
Model	B	Std. error	Beta	t	Sig.	Lower bound	Upper bound
Constant	63.984	29.416	-	2.175	0.032	5.586	122.383
TCM constitutions	2.892	1.022	0.264	2.830	0.006	0.864	4.921
Age	0.042	0.298	0.016	－0.139	0.890	0.633	0.550
Pathological type	3.474	3.081	0.110	1.128	0.262	－2.643	9.591
Tumour Stages	6.720	5.008	0.157	1.342	0.183	－3.223	16.663
ER+	－33.908	23.056	0.150	－1.471	0.145	－79.679	11.863
PR+	2.315	10.842	0.022	0.214	0.831	－19.209	23.839
Ki-67	－5.220	5.169	0.099	－1.010	0.315	－15.482	5.043
lymphatic node transfern	－23.203	7.279	0.380	－3.188	0.002	－37.653	－8.754
Time of illness	2.115	1.094	0.197	1.934	0.056	0.056	4.287
Treatment programme	1.458	1.459	0.105	1.000	0.320	－1.438	4.354
Endocrine therapy	4.164	2.089	0.206	1.993	0.049	0.017	8.311
Surgical procedure	－1.112	6.411	0.018	0.173	0.863	－13.840	11.616

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