Psychophysiological changes during breast cancer treatment: a longitudinal analysis of subjective and objective...

Advances in early detection and treatment of breast cancer have led to improved survival rates, shifting attention toward the physical and psychological consequences of treatment. Adjuvant therapies are frequently associated with fatigue, reduced quality of life, sleep disturbances, and psychological distress, yet longitudinal data capturing changes in both subjective and objective health indicators during treatment remain limited. The present study aimed to examine changes in selected psychophysiological characteristics in breast cancer patients from diagnosis through completion of adjuvant treatment.

A longitudinal design with two assessment points was employed: before treatment initiation and after completion of adjuvant therapy. The sample consisted of 75 women with breast cancer (mean age = 52.04; sd = 11.63). Self-report measures assessed fatigue (MFI), quality of life (EORTC QLQ-C30), anxiety and depression (HADS), sleep quality (PSQI), and motivation for physical activity (MPAM-R). Objective indicators included body mass index (BMI) and functional exercise capacity measured by the six-minute walk test (6MWT). Changes over time were analyzed using General Linear Models for repeated measures, with age and treatment duration included as covariates. Holm-Bonferroni correction was applied to control for multiple testing.

Following treatment, patients exhibited significant increases in physical and general fatigue and a marked deterioration in the physical component of quality of life. BMI increased modestly but significantly over time. In contrast, no significant change was observed in objectively measured physical fitness (6MWT). Depressive symptoms significantly decreased after treatment, suggesting psychological adaptation despite physical deterioration. Age-related effects indicated greater post-treatment worsening of sleep quality in younger women, whereas older women showed a more pronounced decline in physical quality of life.

The findings reveal a notable discrepancy between subjective health perceptions and objective physical capacity during breast cancer treatment. They underscore the importance of routine monitoring of fatigue, quality of life, and body weight, and support the implementation of individualized, age-sensitive supportive care strategies. Addressing psychophysiological burden during treatment may improve long-term well-being and clinical outcomes in breast cancer survivors.