Exploring the differential experience of breast cancer treatment-related symptoms: a cluster analytic approach.
BACKGROUND
Cancer patients experience multiple concurrent symptoms. This exploratory analysis assessed symptom burden among patients undergoing chemotherapy for breast cancer to identify distinct subgroups of patients who experience differential symptom burden and assessed whether the patient subgroups were associated with deleterious quality of life (QOL) outcomes.


METHODS
Women (N = 133) with stage I and II breast cancer undergoing adjuvant chemotherapy after primary surgery were evaluated at baseline and at the end of chemotherapy using the Memorial Symptom Assessment Scale (MSAS) and the SF-36 QOL questionnaire. Post treatment MSAS symptoms were included in hierarchical cluster analysis. Two patient subgroups were identified that corresponded to a high-symptom prevalence group and a low-symptom group.


CONCLUSIONS
No marked, statistically significant differences were found between groups on demographic, symptoms, QOL, or treatment variables at baseline. Patients in the high-symptom cluster were more likely to have stage I disease (p < 0.05). The two groups of patients showed significant differences in end-of-treatment symptoms and QOL scores (p < 0.05). The high-symptom burden group was more likely to report greater symptom prevalence and poorer QOL.


CONCLUSIONS
Future research needs to examine why these differences occur despite similarities in treatment and how symptom burden can be reduced for the high-symptom prevalence group.
Department of Interdisciplinary Oncology, H. Lee Moffitt Cancer Center and University of South Florida, 12902 Magnolia Drive, MRC-CANCONT, Tampa, FL, 33612, USA. clement.gwede@moffitt.org
Clement K
CK
Gwede
Brent J
BJ
Small
Pamela N
PN
Munster
Michael A
MA
Andrykowski
Paul B
PB
Jacobsen
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D016000:Cluster Analysis; D005260:Female; D006801:Humans; D008875:Middle Aged; D010865:Pilot Projects; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology; D011795:Surveys and Questionnaires; D055815:Young Adult
D000970:Antineoplastic Agents