Living beyond survival: Experiences of self-management among long-term breast cancer survivors - A qualitative study.

Background: Over the long term, breast cancer is associated with multiple symptoms and comorbidities that often cluster and intensify one another. Long-term breast cancer survivors face the challenge of transitioning from treatment-focused care to a non-treatment-oriented life. Objective: To explore long-term breast cancer survivors' experiences of managing cancer-related symptoms and provide insights to inform survivorship care. Design: A qualitative descriptive study. Methods: A purposive sampling approach was used to recruit long-term breast cancer survivors from a tertiary hospital in Guangzhou, China. Semi-structured interviews were conducted between June and July 2025, audio-recorded and transcribed verbatim. Data were analyzed using thematic analysis, with NVivo 12 software employed for data management. Results: Eighteen female breast cancer survivors participated. Three themes emerged: (1) The persistent shadow - manifestations and burden of long-term symptoms; (2) Navigating the new normal: self-management strategies and adaptations; and (3) Enablers and obstacles in the self-management journey. Conclusion: Long-term breast cancer survivors face ongoing symptom burdens and employ diverse self-management strategies, yet their understanding of self-management varies, and effective self-management should address psychological well-being alongside physical health. Tailored education and technological tools may help overcome barriers, particularly among older survivors with lower health literacy.