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The fear of cancer recurrence (FCR) is one of the most frequently expressed concerns among breast cancer (BC) survivors. This study explored profiles of FCR and adaptation indicators, centring on body image and 'bouncing back', 18 months post-diagnosis. It also examined psycho-social predictors for profiles. The study sample comprised 494 women from Finland, Italy, Portugal, and Israel, diagnosed with Stage I-III BC. Participants' ages ranged from 40 to 70 years (M = 54.92, SD = 8.22) and were assessed at diagnosis and after 3 and 18 months. Participants completed self-report questionnaires, including Fear of Cancer Recurrence Inventory-Short Form, Body Image Subscale- from the quality-of-life questionnaire- BC module, Bounce Back single self-report item, Hospital Anxiety and Depression Scale, modified Medical Outcomes Study Social Support Survey along with medical-social-demographic data. Three profiles of FCR and adaptation indicators were identified: (1) the Adaptive Profile (67% of the sample), indicated relatively low levels of FCR and higher levels of body image and bounce back; (2) the Distressed Profile (19%), marked by higher FCR compared to the other profiles, moderate body image and bouncing back; and (3) the Body Image Impairment Profile (14%), with participants reporting the lowest body image levels relative to the other two profiles. Depression levels 3 months post-diagnosis predicted more challenged coping FCR profiles. This study identifies distinct patterns of FCR and adaptation during the initial phase of BC survivorship. While most women adjust well, a considerable portion continue to face challenges. Among women experiencing elevated depressive symptoms early in the disease, these difficulties may be further compounded, highlighting the importance of early screening and timely preventive intervention.