Activity limitation and clustering of symptoms in breast cancer patients

Abstract

Listen

Translate article

8540 Background: While previous cancer symptom research has been focused on individual symptoms, more recent studies have attempted to identify symptom clusters in breast cancer patients. However, there has been no large study that has examined both clustering of symptoms and activity limitation in breast cancer patients. Methods: Data were taken from a survey study of 1,011 patients found to have histologically confirmed breast cancer, identified by the Metropolitan Detroit Cancer Surveillance System. Patients were surveyed at both 3 and 12 months after diagnosis. Survey data on 1,054 control participants were also obtained for matching variables. Participants were asked whether or not they had each of 21 symptoms, and whether or not they attributed any activity limitation to each symptom. Results: Of 21 symptoms examined, prevalence of symptoms listed in Table 1 was significantly higher in cancer patients than in controls (p<0.05) at baseline. Though the prevalence of each symptom decreased significantly at follow up, each symptom remained significantly more prevalent than in the control group, with the exception of depression. Activity limitation attributed to 4 of the 5 symptoms listed in Table 1 was significantly higher than that of controls, and this difference persisted at follow up. Symptoms tended to cluster together amongst breast cancer patients. For example, at baseline, 73% of patients with depression also reported fatigue, and 30% of patients with pains in chest area also reported both fatigue and depression. These associations persisted at follow up. Symptoms were significantly correlated with each other at baseline (p<0.00005), with correlation coefficients ranging from 0.13 to 0.26, with most correlations remaining significant at follow up. Conclusion: In a large survey of breast cancer patients, symptoms were found to be associated with significant activity limitation, and tended to cluster together. This correlation persists at 12 months after diagnosis, even after treatment is complete. [Table: see text] No significant financial relationships to disclose.