Objective: Cancer-related fatigue (CRF) is highly prevalent among breast cancer survivors. This study aimed to identify CRF subgroups in breast cancer survivors using latent profile analysis (LPA) and to examine the effects of rumination on CRF through anxiety, depression, and fear of cancer recurrence.
Methods: A total of 201 women diagnosed with early-stage breast cancer completed standardized assessments of fear of cancer recurrence, rumination, anxiety, depression, and cancer-related fatigue. Latent profile analysis was conducted to identify distinct CRF profiles, and differences in psychological variables across groups were examined. Mediation analyses were performed using the PROCESS macro with bootstrapping (5,000 samples) to test indirect effects.
Results: LPA identified three distinct profiles: low (50.2%), moderate (37.3%), and high (12.4%). The model demonstrated excellent classification quality (entropy=0.80; average posterior probabilities=0.89–0.93). Participants in the high-CRF group reported significantly higher levels of rumination, anxiety, depression, and fear of recurrence than those in the other two groups (all p<0.001, η²=0.10–0.30). Multinomial regression analysis showed that depression, anxiety, and fear of cancer recurrence significantly predicted membership in the high-CRF group. Mediation analyses indicated that rumination predicted CRF indirectly through depression (b=0.07, 95% confidence interval (CI) [0.01, 0.15]), anxiety (b=0.20, 95% CI [0.05, 0.34]), and fear of recurrence (b=0.17, 95% CI [0.04, 0.30]), jointly accounting for 32.6% of the total effect.
Conclusion: The findings suggest that fear of recurrence, anxiety, and depression may increase vulnerability to CRF. The results also underscore the importance of targeting transdiagnostic processes such as rumination in psychological interventions for breast cancer survivors.