{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T15:41:34Z","timestamp":1785426094641,"version":"3.56.0"},"reference-count":92,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000780","name":"European Commission","doi-asserted-by":"crossref","award":["777167"],"award-info":[{"award-number":["777167"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"crossref"}]},{"award":["777167"],"award-info":[{"award-number":["777167"]}],"id":[{"id":"https:\/\/ror.org\/00k4n6c32","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Background\/Objectives: Patients with breast cancer show substantial heterogeneity in terms of psychological adjustment following diagnosis. We aimed to characterize longitudinal trajectories of quality of life (QoL) and depressive symptoms during the first 18 months post-diagnosis and to identify robust clinical, psychosocial, and behavioral predictors associated with distinct adjustment pathways. Methods: Women (N = 538; mean age 55.4 years; range 40\u201370) with operable breast cancer (stages I\u2013III) were drawn from the multicenter BOUNCE cohort. QoL (Global Health Status\/QoL scale of the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30) and depressive symptoms (depression subscale of the Hospital Anxiety and Depression Scale) were assessed at baseline and months 3, 6, 9, 12, 15 and 18. Latent class growth analysis and growth mixture modeling identified distinct trajectory classes. Associations between early predictors and trajectory membership were examined using logistic regression combined with elastic net regularization. Results: Depression trajectories demonstrated heterogeneity, with groups characterized by persistent resilience (59.7%), stable moderate\/high (25.3%), delayed onset (5.0%), and recovery (10.0%). QoL trajectories ranged from stable excellent (13.2%) and stable high (40.7%) to moderate (31.4%) and persistent low\/deteriorating (6.9%), as well as a distinct recovering trajectory (7.8%). Trajectory differentiation was primarily driven by psychological resources, symptom burden, functional status, and coping processes, alongside specific contributions from clinical factors. Conclusions: Distinct subgroups of women with breast cancer follow divergent adjustment pathways. These findings highlight the multidimensional nature of resilience and support the need for tailored interventions that promote long-term well-being beyond simple risk reduction.<\/jats:p>","DOI":"10.3390\/jpm16040209","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T07:25:12Z","timestamp":1775633112000},"page":"209","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["In Silico Psycho-Oncology: Understanding Resilience Pathways in Breast Cancer\u2014Determinants of Longitudinal Depression and Quality-of-Life Trajectories"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8455-2918","authenticated-orcid":false,"given":"Eleni","family":"Kolokotroni","sequence":"first","affiliation":[{"name":"In Silico Oncology and In Silico Medicine Group, Institute of Communication and Computer Systems, School of Electrical and Computer Engineering, National Technical University of Athens, Iroon Polytechniou 9, 15780 Zografos, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2274-1937","authenticated-orcid":false,"given":"Paula","family":"Poikonen-Saksela","sequence":"additional","affiliation":[{"name":"Department of Oncology, Faculty of Medicine, Helsinki University Hospital, University of Helsinki, 00029 HUS Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5589-8837","authenticated-orcid":false,"given":"Ruth","family":"Pat-Horenczyk","sequence":"additional","affiliation":[{"name":"School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem 91905, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2287-4799","authenticated-orcid":false,"given":"Berta","family":"Sousa","sequence":"additional","affiliation":[{"name":"Breast Unit, Champalimaud Clinical Centre, Champalimaud Foundation, 1400-038 Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5071-3007","authenticated-orcid":false,"given":"Albino J.","family":"Oliveira-Maia","sequence":"additional","affiliation":[{"name":"Champalimaud Research & Clinical Centre, Champalimaud Foundation, 1400-038 Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1382-6779","authenticated-orcid":false,"given":"Ketti","family":"Mazzocco","sequence":"additional","affiliation":[{"name":"Istituto Europeo di Oncologia, 20141 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9917-4486","authenticated-orcid":false,"given":"Haridimos","family":"Kondylakis","sequence":"additional","affiliation":[{"name":"Foundation for Research and Technology\u2013Hellas, 70013 Heraklion, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios S.","family":"Stamatakos","sequence":"additional","affiliation":[{"name":"In Silico Oncology and In Silico Medicine Group, Institute of Communication and Computer Systems, School of Electrical and Computer Engineering, National Technical University of Athens, Iroon Polytechniou 9, 15780 Zografos, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1111\/j.1365-2753.2011.01709.x","article-title":"A P5 cancer medicine approach: Why personalized medicine cannot ignore psychology","volume":"17","author":"Pravettoni","year":"2011","journal-title":"J. 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