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Identification of Breast Cancer Survivors With High Symptom Burden
Meagan S Whisenant1, Loretta A Williams, Tito Mendoza
1Author Affiliations: Jane and Robert Cizik School of Nursing, The University of Texas Health Science Center at Houston (Dr Whisenant); and Departments of Symptom Research (Drs Whisenant, Williams, Mendoza, Cleeland, and Chen) and General Oncology (Dr Fisch), The University of Texas MD Anderson Cancer Center, Houston; Aim Specialty Health, Chicago, Illinois (Dr Fisch); and Chongqing Medical University, School of Public Health, Chongqing Municipality, China (Dr Shi).
Background:
While women diagnosed with breast cancer have increased survival when compared with other cancers, survivorship may include residual symptom burden from treatment and continuing endocrine therapies.
Objective:
The objective of this study was to identify subgroups of breast cancer survivors experiencing similar symptom severity.
Methods:
Participants were 498 women with breast cancer, not on active treatment. Symptom severity was self-reported using the MD Anderson Symptom Inventory. Target symptoms were included in a latent profile analysis. Factors related to subgroup membership and differences in quality of life (QOL) and functioning were explored using logistic regression.
Results:
Mean age was 60.11 (SD, 11.32) years, 86.1% were white, and 79.1% were receiving endocrine therapy. Target symptoms included fatigue (reported at ≥5 by 22.8% of women), sleep disturbance (24.8%), and trouble remembering (17.2%). Two subgroups were identified: low symptom severity (77.0% of women) and high (23.0%). Older women (odds ratio [OR], 0.971; 95% confidence interval [CI], 0.952-0.989) and employed women (OR, 0.621; 95% CI, 0404-0.956) were less likely to be in the high subgroup; women with poorer performance status (OR, 1.653; 95% CI, 1.188-2.299) were more likely to be in the high subgroup. Women in the high subgroup reported lower QOL (P = .000) and greater interference with functioning (P = .000).
Conclusions:
Two subgroups of women with distinct symptom severity were identified.
Implications For Practice:
Identification of women at risk for high symptoms during survivorship may allow clinicians to intensify their approach to symptom management, thereby mitigating poor outcomes and impairments in QOL.
