{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T21:44:05Z","timestamp":1789163045407,"version":"build-2803163510"},"reference-count":70,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T00:00:00Z","timestamp":1752710400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Aims: To systematically review and synthesize qualitative research exploring the Breast Cancer Survivors (BCSs)\u2019 perception of health promotion interventions and informing strategies to mitigate recurrence risk within five years post-treatment and improve clinical outcomes. Specifically, this study addresses the question: \u201cHow do women diagnosed with breast cancer perceive health promotion interventions for recurrence prevention?\u201d Design: A systematic review and qualitative meta-synthesis were performed. Data Sources: A systematic search of scientific databases (CINAHL, MEDLINE, and Scopus) was undertaken in November 2024. The reference list was cross-referenced and hand-searched to identify additional articles. Review Methods: Studies were included if they met the following criteria: they were primary qualitative studies focusing on BCSs within five years post-treatment, involving participants who had completed surgery, radiotherapy, or chemotherapy in the same time frame, as this period is critical for monitoring recurrence and implementing health promotion interventions. Only studies published in peer-reviewed journals and written in Italian, English, French, or Spanish were considered, provided that an abstract and the full text were available. Moreover, eligible studies had to be conducted in high-income or middle-income countries. Studies were excluded if they focused exclusively on advanced or metastatic breast cancer, if they involved mixed cancer populations without reporting separate data for BCSs, or if they were non-qualitative studies or gray literature. The review study protocol was registered in the PROSPERO database (CRD42024626033). Results: The literature search identified 490 records, 13 articles from databases, and 3 articles identified via other methods (web and citation searching) that met inclusion criteria. A narrative synthesis approach allowed the emerging five themes: (I) Challenges, (II) Self-motivation and empowerment, (III) The relationships as a facilitator, (IV) Barriers to change, and (V) Proactive support strategies. Conclusions: Addressing internal and external factors that influence health behaviors is essential to improve adherence, reduce recurrence risk, and enhance quality of life. Tailored interventions, social support, and healthcare engagement are crucial in this effort. Impact: Our meta-synthesis highlighted significant challenges as well as valuable resources for health promotion among BCSs, suggesting practical and tailored approaches to improving the adoption of healthy behaviors, supported by relationships and targeted support strategies.<\/jats:p>","DOI":"10.3390\/ijerph22071131","type":"journal-article","created":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T14:13:43Z","timestamp":1752761623000},"page":"1131","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Breast Cancer Survivors\u2019 Perception on Health Promotion and Healthy Lifestyle: A Systematic Review and Qualitative Meta-Synthesis"],"prefix":"10.3390","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0738-9712","authenticated-orcid":false,"given":"Luca","family":"Guardamagna","sequence":"first","affiliation":[{"name":"Department of Orthopedics and Traumatology, Istituto di Cura Citt\u00e0 di Pavia, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0276-1925","authenticated-orcid":false,"given":"Orejeta","family":"Diamanti","sequence":"additional","affiliation":[{"name":"Healthcare Professions, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy"},{"name":"Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanna","family":"Artioli","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Casole","sequence":"additional","affiliation":[{"name":"Integrated Home Care and Home Palliative Care Units, Fondazione Conte Franco Cella di Rivara Onlus, 27043 Broni, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Bernardi","sequence":"additional","affiliation":[{"name":"Healthcare Professions, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Bonadies","sequence":"additional","affiliation":[{"name":"Healthcare Professions, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Zennaro","sequence":"additional","affiliation":[{"name":"Healthcare Professions, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1883-1943","authenticated-orcid":false,"given":"Gloria Maria","family":"Modena","sequence":"additional","affiliation":[{"name":"Welfare Services Area, IRCCS Istituto Clinico Humanitas, 20089 Rozzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiziana","family":"Nania","sequence":"additional","affiliation":[{"name":"Training Office, IRCCS Policlinico San Donato, 20097 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8220-8347","authenticated-orcid":false,"given":"Federica","family":"Dellafiore","sequence":"additional","affiliation":[{"name":"Department of Life Health Sciences and Health Professions, Link Campus University, 00165 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,17]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2025, January 05). Breast Cancer. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/breast-cancer."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Afkar, A., Jalilian, H., Pourreza, A., Mir, H., Sigaroudi, A.E., and Heydari, S. (2021). Cost analysis of breast cancer: A comparison between private and public hospitals in Iran. BMC Health Serv. Res., 21.","DOI":"10.1186\/s12913-021-06136-6"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1007\/s10549-018-4670-9","article-title":"Living with chronic pain: Perceptions of breast cancer survivors","volume":"169","author":"Bao","year":"2018","journal-title":"Breast Cancer Res. Treat."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"922","DOI":"10.1016\/j.ejso.2006.06.001","article-title":"Patterns of breast cancer relapse","volume":"32","author":"Elder","year":"2006","journal-title":"Eur. J. Surg. Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1093\/pm\/pnaa363","article-title":"Psychological factors are associated with pain at all time frames after breast cancer surgery: A systematic review with meta-analyses","volume":"22","author":"Moloney","year":"2021","journal-title":"Pain Med."},{"key":"ref_6","first-page":"371","article-title":"Living with breast cancer: The experiences and meaning-making among women in Southern Thailand","volume":"25","author":"Liamputtong","year":"2016","journal-title":"Eur. J. Cancer Care"},{"key":"ref_7","unstructured":"National Cancer Institute (2025, June 06). Division of Cancer Control & Population Sciences, Available online: https:\/\/cancercontrol.cancer.gov\/ocs\/definitions."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1186\/s13058-024-01881-y","article-title":"Metastatic recurrence in women diagnosed with non-metastatic breast cancer: A systematic review and meta-analysis","volume":"26","author":"Morgan","year":"2024","journal-title":"Breast Cancer Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1158\/1055-9965.EPI-20-1029","article-title":"Effects of diet and exercise-induced weight loss on biomarkers of inflammation in breast cancer survivors: A systematic review and meta-analysis","volume":"30","author":"Bruinsma","year":"2021","journal-title":"Cancer Epidemiol. Biomark. Prev."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"245","DOI":"10.3322\/caac.21591","article-title":"American Cancer Society guideline for diet and physical activity for cancer prevention","volume":"70","author":"Rock","year":"2020","journal-title":"CA Cancer J. Clin."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"102162","DOI":"10.1016\/j.ejon.2022.102162","article-title":"Recreational physical activity reduces breast cancer recurrence in female survivors of breast cancer: A meta-analysis","volume":"59","year":"2022","journal-title":"Eur. J. Oncol. Nurs."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1001\/jamaoncol.2015.5679","article-title":"Mediterranean Diet and Its Association with Reduced Invasive Breast Cancer Risk","volume":"2","author":"Berrino","year":"2016","journal-title":"JAMA Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1177\/1054773814553298","article-title":"Healthy Lifestyle Behaviors of Breast Cancer Survivors","volume":"24","author":"DeNysschen","year":"2015","journal-title":"Clin. Nurs. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1016\/j.annonc.2020.09.010","article-title":"ESO\u2013ESMO 4th international consensus guidelines for breast cancer in young women (BCY4)","volume":"31","author":"Cardoso","year":"2020","journal-title":"Ann. Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1007\/s12013-014-0459-6","article-title":"Breast Cancer: Epidemiology and Etiology","volume":"72","author":"Tao","year":"2015","journal-title":"Cell Biochem. Biophys."},{"key":"ref_16","first-page":"402","article-title":"DianaWeb: Un progetto dimostrativo per migliorare la prognosi in donne con carcinoma mammario attraverso gli stili di vita","volume":"9","author":"Villarini","year":"2015","journal-title":"Epidemiol. Prev."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.maturitas.2018.07.010","article-title":"Physical activity and breast cancer survivors: Importance of adherence, motivational interviewing and psychological health","volume":"116","author":"Pudkasam","year":"2018","journal-title":"Maturitas"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1158\/1055-9965.EPI-19-0872","article-title":"Adherence to Dietary Recommendations among Long-Term Breast Cancer Survivors and Cancer Outcome Associations","volume":"29","author":"Wang","year":"2020","journal-title":"Cancer Epidemiol. Biomark. Prev."},{"key":"ref_19","unstructured":"WCRF\/AICR (2025, July 09). Research and Policy | World Cancer Research Fund. Available online: https:\/\/www.wcrf.org\/research-policy\/."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e020313","DOI":"10.1136\/bmjopen-2017-020313","article-title":"Lifestyle advice to cancer survivors a qualitative study on the perspectives of health professionals","volume":"8","author":"Koutoukidis","year":"2018","journal-title":"BMJ Open"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.ejon.2019.06.001","article-title":"Lifestyle change experiences among breast cancer survivors participating ina pilot intervention A narrative thematic analysis","volume":"41","author":"Yufe","year":"2019","journal-title":"Eur. J. Oncol. Nurs."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"E19","DOI":"10.1097\/NCC.0000000000000306","article-title":"We as Spouses Have Experienced a Real Disaster! A Qualitative Study of Women with Breast Cancer and Their Spouses","volume":"39","author":"Karayurt","year":"2016","journal-title":"Cancer Nurs."},{"key":"ref_23","first-page":"1193","article-title":"Experiences of Breast Cancer Survivors Participating in a Tailored Exercise Intervention: A Qualitative Study","volume":"34","author":"Luoma","year":"2014","journal-title":"Anticancer Res."},{"key":"ref_24","unstructured":"Jirojwong, S., Johnson, M., and Welch, A. (2014). Research Methods in Nursing and Midwifery: Pathways to Evidence Based Practice, Oxford University Press."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1177\/1049732303253462","article-title":"Metasynthesis: The state of the art\u2014So far","volume":"13","author":"Finfgeld","year":"2003","journal-title":"Qual. Health Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Aromataris, E., Lockwood, C., Porritt, K., Pilla, B., and Jordan, Z. (2024). JBI Manual for Evidence Synthesis, JBI.","DOI":"10.46658\/JBIMES-24-01"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1080\/02763869.2019.1588072","article-title":"PROSPERO: An International Register of Systematic Review Protocols","volume":"38","author":"Schiavo","year":"2019","journal-title":"Med. Ref. Serv. Q."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1435","DOI":"10.1177\/1049732312452938","article-title":"Beyond PICO: The SPIDER Tool for Qualitative Evidence Synthesis","volume":"22","author":"Cooke","year":"2012","journal-title":"Qual. Health Res."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1038\/sj.ebd.6400602","article-title":"Handsearching still a valuable element of the systematic review","volume":"9","author":"Richards","year":"2008","journal-title":"Evid. Based Dent."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1186\/s13643-016-0384-4","article-title":"Rayyan\u2014A web and mobile app for systematic reviews","volume":"5","author":"Ouzzani","year":"2016","journal-title":"Syst. Rev."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1186\/2046-4053-3-114","article-title":"Considering methodological options for reviews of theory: Illustrated by a review of theories linking income and health","volume":"3","author":"Campbell","year":"2014","journal-title":"Syst. Rev."},{"key":"ref_33","unstructured":"Pearson, A., and Field, J. (2011). JBI Critical Appraisal Checklist for Qualitative Research, JBI."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1258\/1355819054308576","article-title":"Systematically reviewing qualitative and quantitative evidence to inform management and policy-making in the health field","volume":"10","author":"Mays","year":"2005","journal-title":"J. Health Serv. Res. Policy"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1044","DOI":"10.1002\/pon.4279","article-title":"A qualitative insight into self-management experience among Chinese breast cancer survivors","volume":"26","author":"Cheng","year":"2017","journal-title":"Psychooncology"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1080\/09638288.2018.1506512","article-title":"Exploring tensions within young breast cancer survivors\u2019 physical activity, nutrition and weight management beliefs and practices","volume":"42","author":"Milosevic","year":"2020","journal-title":"Disabil. Rehabil."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"E40","DOI":"10.1097\/NCC.0000000000000283","article-title":"From Patient to Survivor: Women\u2019s Experience With Breast Cancer After 5 Years","volume":"39","author":"Fang","year":"2016","journal-title":"Cancer Nurs."},{"key":"ref_38","first-page":"e13303","article-title":"Diet and cognitive function in cancer survivors with cancer-related cognitive impairment A qualitative study","volume":"29","author":"Coro","year":"2020","journal-title":"Eur. J. Cancer Care"},{"key":"ref_39","first-page":"e1337","article-title":"Acceptability of a structured diet and exercise weight loss intervention in breast cancer survivors living with an overweight condition or obesity: A qualitative analysis","volume":"4","author":"Beckenstein","year":"2021","journal-title":"Cancer Rep."},{"key":"ref_40","first-page":"139","article-title":"Exploration of Exercise Outcome Expectations among Breast Cancer Survivors","volume":"176","author":"Hirschey","year":"2017","journal-title":"Cancer Nurs."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"2038","DOI":"10.3109\/09638288.2013.802378","article-title":"A qualitative exploration of barriers and motivators to physical activity participation in women treated for breast cancer","volume":"35","author":"Brunet","year":"2013","journal-title":"Disabil. Rehabil."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1111\/jocn.15114","article-title":"The experience of cancer-related fatigue, exercise and exercise adherence among women breast cancer survivors Insights from focus group interviews","volume":"29","author":"Kim","year":"2020","journal-title":"J. Clin. Nurs."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1111\/jhn.13086","article-title":"\u2018It\u2019s like being pushed into sea on a boat with no oars\u2019: Breast cancer survivorship and rehabilitation support in Ireland and the UK","volume":"36","author":"Deery","year":"2023","journal-title":"J. Hum. Nutr. Diet."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Khajoei, R., Azadeh, P., ZohariAnboohi, S., Ilkhani, M., and Nabavi, F.H. (2024). Breast cancer survivorship needs: A qualitative study. BMC Cancer, 24.","DOI":"10.1186\/s12885-024-11834-5"},{"key":"ref_45","first-page":"472","article-title":"Health Behavior Changes among Survivors of Breast Cancer after Treatment Completion","volume":"24","author":"Chumdaeng","year":"2020","journal-title":"Pac. Rim Int. J. Nurs. Res."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/j.ejon.2015.10.005","article-title":"\u201cI just have to move on\u201d: Women\u2019s coping experiences and reflections following their first year after primary breast cancer surgery","volume":"21","author":"Drageset","year":"2016","journal-title":"Eur. J. Oncol. Nurs."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1177\/1043659618771142","article-title":"Fear of Recurrence in Turkish Breast Cancer Survivors: A Qualitative Study","volume":"30","year":"2019","journal-title":"J. Transcult. Nurs."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1097\/NCC.0000000000000641","article-title":"Self-management Needs of Breast Cancer Survivors After Treatment: Results From a Focus Group Interview","volume":"43","author":"Kim","year":"2020","journal-title":"Cancer Nurs."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1089\/jayao.2024.0021","article-title":"Young Adult Cancer Survivors\u2019 Perspectives on Cancer\u2019s Impact on Different Life Areas Post-Treatment: A Qualitative Study","volume":"13","author":"Arem","year":"2024","journal-title":"J. Adolesc. Young Adult Oncol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"43","DOI":"10.15171\/jcs.2016.005","article-title":"The Lived Experience of Iranian Women Confronting Breast Cancer Diagnosis","volume":"5","author":"Mehrabi","year":"2016","journal-title":"J. Caring Sci."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Michaelson, V., Pilato, K.A., and Davison, C.M. (2021). Family as a health promotion setting: A scoping review of conceptual models of the health-promoting family. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0249707"},{"key":"ref_52","first-page":"2437","article-title":"The self-care practices of family caregivers of persons with poor prognosis cancer: Differences by varying levels of caregiver well-being and preparedness","volume":"25","author":"Taylor","year":"2017","journal-title":"Support. Care Cancer"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1038\/s41416-022-02012-0","article-title":"Comment on \u201cThe lingering mysteries of metastatic recurrence in breast cancer\u201d","volume":"128","author":"Hudson","year":"2023","journal-title":"Br. J. Cancer"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1177\/10497323231158629","article-title":"Empowering Cancer Survivors in Managing Their Own Health: A Paradoxical Dynamic Process of Taking and Letting Go of Control","volume":"33","author":"Avery","year":"2023","journal-title":"Qual. Health Res."},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Shengyao, Y., Salarzadeh Jenatabadi, H., Mengshi, Y., Minqin, C., Xuefen, L., and Mustafa, Z. (2024). Academic resilience, self-efficacy, and motivation: The role of parenting style. Sci. Rep., 14.","DOI":"10.1038\/s41598-024-55530-7"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.maturitas.2021.06.008","article-title":"Motivational strategies to improve adherence to physical activity in breast cancer survivors: A systematic review and meta-analysis","volume":"152","author":"Pudkasam","year":"2021","journal-title":"Maturitas"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"47","DOI":"10.4236\/abcr.2014.32007","article-title":"Social Support Provided to Women Undergoing Breast Cancer Treatment: A Study Review","volume":"3","author":"Fernandes","year":"2014","journal-title":"Adv. Breast Cancer Res."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"20","DOI":"10.23937\/2469-5718\/1510020","article-title":"A community-based exercise and support group program improves quality of life in African-American breast cancer survivors: A quantitative and qualitative analysis","volume":"1","author":"Nock","year":"2015","journal-title":"Int. J. Sports Exerc Med."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/j.critrevonc.2009.06.003","article-title":"Associations of social networks with cancer mortality: A meta-analysis","volume":"75","author":"Pinquart","year":"2010","journal-title":"Crit. Rev. Oncol. Hematol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"e38333","DOI":"10.2196\/38333","article-title":"Digital health interventions for adult patients with cancer evaluated in randomized controlled trials: Scoping review","volume":"25","author":"Lee","year":"2023","journal-title":"J. Med. Internet Res."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"2283","DOI":"10.1002\/ijc.35320","article-title":"Socio-economic inequalities in second primary cancer incidence: A competing risks analysis of women with breast cancer in England between 2000 and 2018","volume":"156","author":"Golani","year":"2025","journal-title":"Int. J. Cancer"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"102118","DOI":"10.1016\/j.canep.2022.102118","article-title":"Socioeconomic status and its relation with breast cancer recurrence and survival in young women in the Netherlands","volume":"77","author":"Rachet","year":"2022","journal-title":"Cancer Epidemiol."},{"key":"ref_63","first-page":"39","article-title":"Socioeconomic Disparities in Breast Cancer Care: Addressing Global Challenges in Oncology Outcomes","volume":"14","author":"Opia","year":"2025","journal-title":"Int. J. Comput. Appl. Technol. Res."},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Pontillo, M., Trio, R., Rocco, N., Cinquerrui, A., Di Lorenzo, M., Catanuto, G., Magnoni, F., Calenda, F., Castiello, C.L., and Ingenito, M. (2025). Dietary Interventions for Breast Cancer Prevention: Exploring the Role of Nutrition in Primary and Tertiary Prevention Strategies. Healthcare, 13.","DOI":"10.3390\/healthcare13040407"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1610","DOI":"10.1158\/1055-9965.EPI-24-0650","article-title":"Racial, Ethnic, and Socioeconomic Disparities in Meeting Physical Activity Guidelines among Female Breast Cancer Survivors in the United States","volume":"33","author":"Wojcik","year":"2024","journal-title":"Cancer Epidemiol. Biomark. Prev."},{"key":"ref_66","first-page":"158","article-title":"How could physical activity decrease the risk of breast cancer development and recurrence?","volume":"52","author":"Meneu","year":"2024","journal-title":"Gynecol. Obstet. Fertil. Senol."},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Wojcik, K.M., Kamil, D., Zhang, J., Wilson, O.W.A., Smith, L., Butera, G., Isaacs, C., Kurian, A., and Jayasekera, J. (2024). A scoping review of web-based, interactive, personalized decision-making tools available to support breast cancer treatment and survivorship care. J. Cancer Surviv.","DOI":"10.1007\/s11764-024-01567-6"},{"key":"ref_68","first-page":"459","article-title":"Living with metastatic breast cancer (LIMBER): Experiences, quality of life, gaps in information, care and support of patients in the UK","volume":"31","author":"Fallowfield","year":"2023","journal-title":"Support. Care Cancer"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1037\/hea0000760","article-title":"Toward a health-promoting system for cancer survivors: Patient and provider multiple behavior change","volume":"38","author":"Spring","year":"2019","journal-title":"Health Psychol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1007\/s11135-005-1098-1","article-title":"A Call for Qualitative Power Analyses","volume":"41","author":"Onwuegbuzie","year":"2007","journal-title":"Qual. Quant."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/22\/7\/1131\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:11:35Z","timestamp":1760033495000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/22\/7\/1131"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,17]]},"references-count":70,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2025,7]]}},"alternative-id":["ijerph22071131"],"URL":"https:\/\/doi.org\/10.3390\/ijerph22071131","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,17]]}}}