Fear of cancer recurrence, a rational reaction to a future health threat, is often experienced by individuals who have undergone cancer treatment. In this manuscript we review recent research and clinical experience from the field of breast cancer, focusing on fear of recurrence with particular interest in the care process, both in terms of choices that patients make and how to intervene. We have included our own clinical observations arising from working with women who have received breast cancer treatment and are experiencing great fear of cancer recurrence. We found that younger women (pre-menopausal) are particularly vulnerable to such fear and may require special attention. This fear is also implicated in treatment decision-making, especially in selection of prophylactic mastectomy rather than breast conservation. Limited psychological intervention to help manage this fear is currently being investigated.