Symptom clusters and quality of life in breast cancer survivors after cancer treatment in a tertiary hospital in Korea

Abstract

We investigated the symptom clusters and effects of symptom clusters on the quality of life of Korean breast cancer survivors. We recruited 241 breast cancer survivors and collected cross-sectional data on their symptoms. To determine inter-relationships among symptoms, a principal component analysis with varimax rotation was performed based on the patient's symptoms (fatigue, nausea/vomiting, pain, dyspnoea, insomnia, appetite loss, constipation, anxiety, depression, systemic therapy side effects, breast symptoms and arm symptoms). The first symptom cluster consisted of psychological (anxiety and depression) and general (appetite loss, fatigue, insomnia and dyspnoea) symptoms, whereas the second symptom cluster consisted of physical (arm symptom, breast symptom, pain and systemic therapy side effects) and gastrointestinal (nausea/vomiting and constipation) symptoms. Subgroup cluster analysis showed that breast cancer survivors with higher-scoring symptoms had significantly poorer quality of life in both psychological-general symptom cluster and physical-gastrointestinal symptom cluster subgroups, with subgroup-specific patterns. The symptom clusters differed depending on stage and functional status of breast cancer survivors. Breast cancer survivors may have a specific pattern of symptom clusters. Some symptom clusters may have a negative impact on the quality of life. Identifying symptom clusters of breast cancer survivors may have clinical implications by improving symptom management.