Relationships among psychoneurological symptoms and levels of C-reactive protein over 2 years in women with early-stage breast cancer.
The aim of the present study was to explore clusters of psychoneurological symptoms and inflammation (levels of C-reactive protein) over time in a cohort of women with early-stage breast cancer. Specifically, we examined the relationships among affective symptoms (depression, anxiety, fatigue, sleep disturbances, pain, and perceived stress), domains of cognitive performance, and levels of peripheral C-reactive over a period of 2 years.



This was a prospective, longitudinal study of 77 women diagnosed with early-stage breast cancer. Data collection, including symptom questionnaires, performance-based cognitive testing, and blood draws, took place at 5 time points: prior to initiating adjuvant chemotherapy, prior to the fourth chemotherapy treatment, and at 6, 12, and 24 months after the initiation of chemotherapy.



Exploratory factor analysis with varimax orthogonal rotation was used to examine the covariance among symptoms at each visit. Using the factor scores and weighted sums, three clusters were identified: global cognition, affective symptoms, and cognitive efficiency. Peripheral levels of C-reactive protein were inversely correlated with the cognitive efficiency factor across time.



The findings suggest that objectively measured domains of cognitive function occur independently of other affective symptoms that are commonly reported by women with breast cancer in long-term survivorship. The cognitive efficiency symptom cluster may be amenable to interventions targeted to biological influences that reduce levels of C-reactive protein.
University of Connecticut School of Nursing, Storrs, CT, USA. angela.starkweather@uconn.edu.
Angela
0000-0001-7168-0144
A
Starkweather
University of Florida College of Nursing, Gainesville, FL, USA.
Debra Lynch
DL
Kelly
Virginia Commonwealth University School of Nursing, Richmond, VA, USA.
Leroy
L
Thacker
Yale University, New Haven, CT, USA.
Michelle L
ML
Wright
Virginia Commonwealth University School of Nursing, Richmond, VA, USA.
Colleen K
CK
Jackson-Cook
University of Florida College of Nursing, Gainesville, FL, USA.
Debra E
DE
Lyon
D000328:Adult; D000368:Aged; D001007:Anxiety / Q000097:blood / Q000209:etiology; D001943:Breast Neoplasms / Q000097:blood* / Q000188:drug therapy / Q000523:psychology; D002097:C-Reactive Protein / Q000378:metabolism*; D017024:Chemotherapy, Adjuvant; D003071:Cognition; D003863:Depression / Q000097:blood / Q000209:etiology; D005221:Fatigue / Q000097:blood / Q000209:etiology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D010146:Pain / Q000097:blood / Q000209:etiology; D011446:Prospective Studies; D012893:Sleep Wake Disorders / Q000097:blood / Q000209:etiology; D011795:Surveys and Questionnaires; D055815:Young Adult
D002097:C-Reactive Protein
Breast cancer; C-reactive protein psychoneurological symptoms; Cognitive impairment; Symptom clusters