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

Abstract

OBJECTIVES: To identify symptom clusters in breast cancer survivors and to determine sociodemographic and clinical characteristics influencing symptom cluster membership. SAMPLE & SETTING: The authors performed a cross-sectional secondary analysis of data obtained froma community-based cancer registry-linked survey with 1,500 breast cancer survivors 6-13 months following a breast cancer diagnosis. METHODS & VARIABLES: Symptom clusters were identified using latent class profile analysis of four patient-reported symptoms (pain, fatigue, sleep disturbance, and depression) with custom PROMIS® short forms. RESULTS: Four distinct classes were identified: symptoms within normal limits (class 1), pain with fatigue and sleep disturbance (class 2), depression with fatigue and sleep disturbance (class 3), and all high symptom burden (class 4). The authors identified four clinically relevant and actionable symptom clusters in early-stage breast cancer survivorship. Certain sociodemographic and clinical characteristics place patients at risk for physical late effects and mental health issues. IMPLICATIONS FOR NURSING: Common symptom clusters may lead to better prevention and treatment strategies that target a group of symptoms. Results also suggest that certain factors place patients at high risk for symptom burden, which can guide tailored interventions. jumin.park@nih.gov. Lee, Ross, and Griffith contributed to the conceptualization and design. Jensen completed the data collection. Lee provided statistical support. All authors provided analysis and contributed to the manuscript preparation. No financial relationships to disclose.

Treating persistent pain after breast cancer: practice gaps and future directions

“…Non-pharmacological approaches, including exercise, activity management, psychosocial support and cognitive behavioural therapy, are widely recognized to be effective and important components of contemporary cancer-related fatigue management [65]. Although they are separate conditions, fatigue and pain have strikingly much in common [67,68]: they are both potentially consuming feelings that urge self-protection and they commonly co-occur in many people living with and beyond cancer [69,70]. In acute situations, pain and fatigue serve clear protective value, but as either condition persists, their protective value decreases, and they can become a primary cause of disability and other secondary problems.…”

Factors Related to Anxiety, Depressive Symptoms and Quality of Life in Breast Cancer

“…Depressive symptoms are also an important psychological consequence of BC. Prevalence rates of depression in people with BC range between 25 and 66.6% [ 5 , 15 , 18 , 19 ].…”

Symptom trajectories in patients with breast cancer: An integrative review

“…Additionally, these symptoms may decrease function and become significant contributors to interrupted medical treatment [ 5 ]. Symptom trajectories are increasingly recognized as vital in symptom management [ 6 ]. Nurses must identify the interrelatedness and change in symptoms to guide timely care [ [7] , [8] , [9] , [10] ].…”