title: Presurgical symptom profiles predict quality of life 2 years after surgery in women with breast cancer.
abstract: OBJECTIVE
  Higher symptom burden in oncology patients is associated with poorer quality of life (QOL). However, the long-term predictive relationship between pre-treatment symptom profiles and QOL is unknown. The aim of this study was to identify subgroups of breast cancer patients based on their presurgical symptom profiles and to examine the predictive effect of group membership on QOL 2 years after surgery.
  
  
  METHODS
  Data were analyzed from a longitudinal study of women's (N = 198) symptoms after breast cancer surgery. Patient subgroups were identified by latent class analysis based on presurgical severity of five symptoms (i.e., attentional and physical fatigue, sleep disturbance, depression, and anxiety). Among these 198 women, quality of life 2 years after surgery was available for 97. Group differences in QOL were examined by general linear models.
  
  
  RESULTS
  We identified four distinct patient groups. Group A (All Low) had low levels of all symptoms. Group B (Low Fatigue and Moderate Mood) was characterized by low attentional and physical fatigue but moderate sleep disturbance, depression, and anxiety. Group C (All Moderate) was characterized by moderate levels of all five symptoms. Group D was characterized by moderate attentional and physical fatigue and severe sleep disturbance, depression, and anxiety (Moderate Fatigue and High Mood). Group D had significantly lower overall QOL scores 2 years after surgery than Group A (p = 0.002).
  
  
  CONCLUSIONS
  Breast cancer patients' presurgical symptom profile had a long-term predictive effect on QOL. Routine assessment of patients' pre-treatment symptom is suggested to identify high risk group.
authors.affiliation: Graduate Institute of Nursing, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan, Taiwan. mechenl@mail.cgu.edu.tw.
authors.forename: Mei-Ling
authors.initials: ML
authors.lastname: Chen
authors.affiliation: Department of Nursing, Fu Jen Catholic University, New Taipei City, Taiwan.
authors.forename: Li-Ni
authors.initials: LN
authors.lastname: Liu
authors.affiliation: Department of Physiological Nursing, School of Nursing, University of California, San Francisco, CA, USA.
authors.forename: Christine
authors.initials: C
authors.lastname: Miaskowski
authors.affiliation: Department of Surgery, Chang Gung Memorial Hospital and School of Medicine, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.
authors.forename: Shin-Cheh
authors.initials: SC
authors.lastname: Chen
authors.affiliation: Department of Internal Medicine, Chang Gung Memorial Hospital and School of Medicine, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.
authors.forename: Yung-Chang
authors.initials: YC
authors.lastname: Lin
authors.affiliation: Department of Rehabilitation Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.
authors.forename: Jong-Shyan
authors.initials: JS
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety; D001943:Breast Neoplasms / Q000150:complications / Q000601:surgery*; D003863:Depression; D005221:Fatigue; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008408:Mastectomy / Q000523:psychology*; D008875:Middle Aged; D011788:Quality of Life; D055815:Young Adult
keywords: Breast cancer; Classification; Quality of life; Symptom burden; Symptom profiles