Five-year longitudinal changes in social, economic, and psychosocial wellbeing among young women with breast cancer in Mexico.
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PURPOSE: Young women with breast cancer (YWBC) face long-term challenges during career building, partnership formation, and childrearing. Most survivorship research has been conducted in high-income countries, with limited longitudinal evidence from low- and middle-income countries (LMICs). We aimed to characterize 5-year longitudinal changes across sociodemographic and financial, relational, fertility, family and caregiving, psychosocial, and health-related domains among YWBC in Mexico. METHODS: We analyzed 526 participants in the Joven and Fuerte prospective cohort (stage I-III breast cancer, age ≤ 40 years) in Mexico. Surveys were completed at baseline, 6 months, as well as 1, 2-3, and 4-5 years post-diagnosis. GEE assessed changes in binary and multinomial outcomes. Global chi-squared or Fisher's exact tests were used descriptively. RESULTS: Participants experienced sustained occupational disruption and economic strain; 75.8% reported a change in occupation and nearly 50% decreased income at 4-5 years. Partnership status was stable; 67.9% remained with the same partner, yet unmet partner support needs persisted. Desire for future children declined from 38.5 to 20.2% at 4-5 years. New comorbidities increased, particularly psychological disorders. While the need for psychological support declined from 66.6 to 42.4%, interest in support groups remained substantial. Health behaviors showed partial recovery; participants meeting recommended exercise levels (≥ 150 min/week) increased from 25.9 to 32.7%. CONCLUSIONS: Mexican YWBC experiences dynamic survivorship trajectories characterized by partial recovery alongside persistent financial, caregiving, and supportive care needs. IMPLICATIONS FOR CANCER SURVIVORS: Survivorship care in LMICs should integrate financial and occupational support, family-centered psychosocial services, and long-term health monitoring for young survivors.