title: Usual and worst symptom severity and interference with function in breast cancer survivors.
abstract: BACKGROUND
  Breast cancer survivors receive routine medical follow-up but are screened less frequently to detect symptom severity and interference with function in daily life.
  
  
  OBJECTIVE
  Among breast cancer survivors, we describe the usual and worst severity of 5 common symptoms and the extent to which these symptoms interfere with general activity and enjoyment of life, we determine the associations among symptoms and the interference items, and we explore associations of interference with function and the most prevalent symptoms.
  
  
  METHODS
  The cross-sectional, descriptive 1-page Breast Cancer Survivor Symptom Survey was mailed to breast cancer survivors identified in a clinical database (ONCOBASE). In total, 184/457 (40.3%) surveys were returned and 162 (35.4%) were used. Participants recorded usual and worst severity of 5 symptoms (fatigue, disturbed sleep, pain, distress, and numbness/tingling) and symptom interference with general activity and enjoyment of life during the past 7 days.
  
  
  RESULTS
  Participants reported usual symptom severity as mild and highest for sleep disturbance, followed by fatigue, distress, numbness/tingling, and pain. Participants recorded worst sleep disturbance and fatigue as moderately severe. Higher pain and fatigue were associated with all other symptoms, whereas disturbed sleep and distress were related to all except numbness/tingling. All symptoms interfered with general activity and enjoyment of life. Pain and numbness/tingling were associated with lower function and disturbed sleep, and made a unique contribution to fatigue.
  
  
  CONCLUSIONS
  Limitations of the study include relatively low response and use of a modification of an established scale.
  
  
  CONCLUSIONS
  Symptoms often coexisted and contributed to interference with daily function. Pain was most consistently associated with interference with function and severity of other symptoms.
authors.affiliation: College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA. aberger@unmc.edu
authors.forename: Ann M
authors.initials: AM
authors.lastname: Berger
authors.forename: Constance
authors.initials: C
authors.lastname: Visovsky
authors.forename: Melody
authors.initials: M
authors.lastname: Hertzog
authors.forename: Shandra
authors.initials: S
authors.lastname: Holtz
authors.forename: Fausto R
authors.initials: FR
authors.lastname: Loberiza
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000150:complications / Q000453:epidemiology* / Q000473:pathology / Q000523:psychology; D003430:Cross-Sectional Studies; D005221:Fatigue / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D012893:Sleep Wake Disorders / Q000453:epidemiology / Q000209:etiology; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000453:epidemiology / Q000209:etiology; D017741:Survivors / Q000706:statistics & numerical data*; D013997:Time Factors