Menopausal symptom clusters and their correlates in women with and without a history of breast cancer: a pooled data analysis from the Women's Wellness Research Program

Abstract

In this study, women after treatment for breast cancer reported a broad range of bothersome climacteric symptoms. Similar symptom clusters were also noted for women with and without a history of breast cancer, though correlates differed across groups, and might reflect different underlying etiologies.

Symptom Clusters in Breast Cancer Survivors: A Latent Class Profile Analysis

“…In the current study, the number of comorbidities was reported as a significant predictor of symptom clusters (class 2 and class 4), characterized by a moderate level of pain. The finding of greater risk for higher symptom burden in cancer survivors with comorbid conditions is consistent with previous studies (Roiland & Heidrich, 2011;Seib et al, 2017;Shi et al, 2011). Seib et al (2017) showed that peripheral somatic symptoms were higher among breast cancer survivors who reported comorbidities.…”

“…The finding of greater risk for higher symptom burden in cancer survivors with comorbid conditions is consistent with previous studies (Roiland & Heidrich, 2011;Seib et al, 2017;Shi et al, 2011). Seib et al (2017) showed that peripheral somatic symptoms were higher among breast cancer survivors who reported comorbidities. Another study in cancer survivors found that the likelihood of high symptom burden increased with the number of comorbidities (Shi et al, 2011).…”

“…These classes represent the symptom experience of breast cancer survivors based on the severity of the symptoms in the clusters: class 1 (symptoms within normal limits), class 2 (pain with fatigue and sleep disturbance), class 3 (depression with fatigue and sleep disturbance), and class 4 (all high symptom burden). Other studies (Avis et al, 2017;Ellis, 2013;Marshall et al, 2016;Mazor et al, 2018;Phligbua et al, 2013;Roiland & Heidrich, 2011;Seib et al, 2017;Shi et al, 2011) have identified symptom clusters in breast cancer survivors; however, little consistency exists in the number (ranging from 2 to 7) and types of symptom clusters identified. Limitations across studies may be attributed to differences in the number of symptoms assessed, instruments, and statistical methodology.…”

“…This is an important finding, given that a large number of breast cancer survivors (about 43%-93%) return to work either full-or part-time within one year of diagnosis (Islam et al, 2014). In addition, evidence from studies regarding the relationship between employment status and symptom clusters is contradictory (Ellis, 2013;Seib et al, 2017;Shi et al, 2011). In the current study, unemployed survivors were more likely to be found in more symptomatic cluster groups (class 2, class 3, class 4) than those who were employed, and the strongest association between employment status and symptom clusters was found in those with the highest symptom burden (class 4).…”

“…Those with higher economic status also may be better able to access appropriate healthcare services and communicate with clinicians after treatment has ended, thereby facilitating better symptom management (DiMartino, Birken, & Mayer, 2017). Because of the cross-sectional approach in this study, it is difficult to determine whether employment status is truly protective against problematic co-occurring symptoms or whether individuals who experience worse symptoms are more likely to leave the workforce (Ellis, 2013;Seib et al, 2017;Shi et al, 2011). Future research investigating longitudinal changes in survivors' employment over time is needed to investigate the link between employment and symptom clusters.…”