Symptom burden and symptom clusters in patients with breast cancer undergoing endocrine therapy: a cross-sectional...

In China, many breast cancer (BC) patients opt for traditional Chinese medicine (TCM) to manage unpleasant symptoms. This study aimed to investigate the symptom clusters among patients with BC who are undergoing endocrine therapy and actively seek TCM treatment in China.

Patients with BC who were undergoing endocrine therapy were recruited. Data on symptom burden were gathered using the M.D. Anderson Symptom Inventory-Traditional Chinese Medicine (MDASI-TCM) and a BC-specific symptom questionnaire. The patient's quality of life (QoL) over the previous week was assessed using single-item QoL scales.

A total of 214 patients were enrolled in the study. The most common moderate to severe symptoms were sleep disturbance (n = 122, 57%), difficulty remembering (n = 105, 49%), sweating (n = 90, 42%), fatigue (n = 89, 41%), and distress (n = 84, 39%). Premenopausal patients experienced higher burdens from sweating, hot flashes, sadness, heat in the palm or solos of the feet, abnormal vaginal discharge, and vaginal dryness (P < 0.05). Six distinct symptom clusters were identified: distress-sleep disturbance, breast-sexual dysfunction, fatigue-related, hot flashes-sweating, pain-joint stiffness, and constipation-bitter taste. The distress-sleep disturbance symptom cluster (B = -0.258, 95% CI -0.383 to -0.133, P < 0.001) and hot flashes-sweating symptom cluster (B = -0.128, 95% CI -0.243 to -0.013, P = 0.029) had a notably detrimental impact on QoL.

This study identified six symptom clusters among BC patients undergoing endocrine therapy and who utilize TCM in China. Clinical and demographic factors should be considered in managing these symptoms. The distress-sleep disturbance and hot flashes-sweating clusters particularly deserve more attention due to their significant impact on QoL.