In a cross-sectional investigation of young women with breast cancer, researchers found that decisional conflict partially mediated the negative relationship between reproductive concerns and health-related quality of life. The study, conducted by Li Song and Zhining Yu, examined the interactions among reproductive concerns, decision conflict, and patient quality of life, identifying statistically significant correlations across all three domains (all p < .001). Mediation testing confirmed that decisional conflict accounted for 25% of the total effect linking reproductive concerns to lower quality of life.
The hospital-based cross-sectional study took place between January and December 2024 and evaluated a sample of 155 young breast cancer patients aged 18 to 40 years. Data collection utilized validated Chinese instruments, including the Reproductive Concerns After Cancer Scale (RCAC-CV), the Decisional Conflict Scale (DCS-CV), and the Functional Assessment of Cancer Therapy-Breast (FACT-B) scale to assess health-related quality of life.
To evaluate direct and indirect pathways, the investigators performed Spearman correlation assessments and a bootstrap mediation analysis utilizing 5,000 resamples. The direct effect of reproductive concern on health-related quality of life was significantly negative (β = −0.48, p < .001). Additionally, reproductive concern demonstrated a significant indirect effect on quality of life operating through increased decisional conflict (β = −0.16, 95% CI: −0.22 to −0.10).
The authors concluded that decisional conflict represents a significant mediator connecting reproductive concerns with impaired quality of life in young female breast cancer patients. Based on these observed associations, they noted that clinical interventions should integrate fertility counseling to address reproductive concerns alongside decision-support tools to mitigate decisional conflict, potentially enhancing overall health-related quality of life in this population.
The investigation tested the specific hypothesis that decision conflict mediates the relationship between reproductive concern and health-related quality of life in young women with breast cancer. To examine these dynamics, the hospital-based, cross-sectional study gathered data across a full calendar year, running from January to December 2024. The sample comprised 155 young breast cancer patients between 18 and 40 years of age. Each participant completed validated Chinese versions of three research instruments: the Reproductive Concerns After Cancer Scale (RCAC-CV), the Decisional Conflict Scale (DCS-CV), and the Functional Assessment of Cancer Therapy-Breast (FACT-B) scale.
To analyze the direct and indirect effects among these variables, the researchers conducted Spearman correlation assessments alongside bootstrap mediation analysis using 5,000 resamples. Significant correlations were established across reproductive concern, decision conflict, and health-related quality of life, with all associations demonstrating significance at p < .001. The resulting mediation analysis confirmed that decision conflict partially mediated the relationship between reproductive concern and health-related quality of life. Within this model, reproductive concern exerted a significant negative direct effect on health-related quality of life (β = −0.48, p < .001), while also producing a significant indirect effect through increased decision conflict (β = −0.16, 95% CI: −0.22 to −0.10). In total, this mediated indirect pathway accounted for 25% of the total effect observed in the patient sample.
Based on the finding that decision conflict functions as a significant mediator linking reproductive concerns to reduced quality of life, the authors outlined targeted clinical directions for young women with breast cancer. They concluded that clinical interventions should integrate fertility counseling specifically to address reproductive concerns. Furthermore, the authors recommended employing decision-support tools to mitigate decision conflict, thereby potentially improving overall health-related quality of life in this population. The study was non-interventional and recorded no applicable clinical trial number.
Subject of Research: Mediating role of decisional conflict between reproductive concerns and quality of life in young breast cancer patients
Article Title: The mediating effect of decision conflict on the relationship between reproductive concern and health-related quality of life in young female with breast cancer
Article References: Song, L., & Yu, Z. (2026). The mediating effect of decision conflict on the relationship between reproductive concern and health-related quality of life in young female with breast cancer. Supportive Care in Cancer, 34(12), Article 1200. https://doi.org/10.1007/s00520-026-11406-2
Image Credits: AI Generated
DOI: 10.1007/s00520-026-11406-2
Keywords: breast cancer, decisional conflict, reproductive concerns, health-related quality of life, oncology, cross-sectional study, patient-reported outcomes, young adults, mediating, effect, decision, conflict
