title: Previous chemotherapy influences the symptom experience and quality of life of women with breast cancer prior to radiation therapy.
abstract: BACKGROUND
  Recent evidence suggests that women who receive treatment for breast cancer may experience multiple symptoms that decrease their functional status and quality of life. Few studies evaluated the occurrence, severity, and distress of multiple symptoms in women at the initiation of radiation therapy (RT) for breast cancer.
  
  
  OBJECTIVE
  This study evaluated for differences in symptoms occurrence, severity, and distress between women with breast cancer who did and did not receive chemotherapy (CTX) prior to RT.
  
  
  METHODS
  Prior to the initiation of RT, patients completed the Memorial Symptom Assessment Scale (MSAS) that evaluated multiple dimensions of 32 symptoms. Differences in occurrence, severity, and distress scores between the 2 CTX groups were evaluated using χ and Mann-Whitney U tests.
  
  
  RESULTS
  The 5 symptoms with the highest occurrence rates were lack of energy, worrying, difficulty sleeping, feeling drowsy, sweats, and pain. Women who received CTX prior to RT experienced twice as many symptoms as women who did not receive CTX. Except from difficulty sleeping, the 5 most prevalent symptoms were not the most severe or distressing. A poorer functional status, a higher comorbidity score, and previous CTX were all predictors of a higher number of symptoms.
  
  
  CONCLUSIONS
  Women with breast cancer experience large numbers of symptoms at the initiation of RT. Previous CTX doubles the number of symptoms that women report.
  
  
  CONCLUSIONS
  Findings suggest that clinicians need to use a multidimensional symptom assessment tool in women with breast cancer at the initiation of RT.
authors.affiliation: Centre for Shared Decision Making and Nursing Research, Oslo University Hospital, Rikshospitalet, Norway. kristin.hofso@rr-research.no
authors.forename: Kristin
authors.initials: K
authors.lastname: Hofsø
authors.forename: Christine
authors.initials: C
authors.lastname: Miaskowski
authors.forename: Kristin
authors.initials: K
authors.lastname: Bjordal
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Cooper
authors.forename: Tone
authors.initials: T
authors.lastname: Rustøen
mesh_terms: D000368:Aged; D001007:Anxiety / Q000453:epidemiology / Q000209:etiology; D001943:Breast Neoplasms / Q000150:complications / Q000188:drug therapy / Q000523:psychology* / Q000532:radiotherapy; D003131:Combined Modality Therapy / Q000009:adverse effects; D005221:Fatigue / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D015404:Nursing Methodology Research; D010146:Pain / Q000453:epidemiology / Q000209:etiology; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology / Q000209:etiology; D013315:Stress, Psychological; D013546:Sweating; D016896:Treatment Outcome