A study examined the social determinants of health affecting the quality of life for young breast cancer survivors, particularly focusing on treatment regret. Conducted with 462 female survivors at the Yazd Radiation Therapy Center, the research used various questionnaires to gather data. Path analysis revealed that socioeconomic status had the most significant positive impact on quality of life. In contrast, treatment regret and fertility concerns negatively affected survivors’ well-being. Treatment regret had a direct negative influence, while fertility concerns impacted quality of life both directly and indirectly through treatment regret. The model showed good fit, suggesting that socioeconomic factors and social support are crucial for improving survivors’ lives. The study emphasized the importance of addressing fertility-related issues in supportive care, highlighting the need for early counseling and awareness of fertility preservation options in Iran. Recommendations include establishing support groups, offering fertility counseling, and implementing follow-up programs to enhance the physical and mental health of young breast cancer survivors.