Breast cancer (BC) itself and curative treatments can cause various concurrent distressing symptoms. These symptoms may “cluster” together and create a synergistic impact compared to a single symptom on patients’ quality of life (QoL). Among various symptom clusters identified in BC population, the cluster of fatigue, sleep disturbance and depression (F-S-D) is frequently reported during active adjuvant chemotherapy. A cross-sectional study was conducted to evaluate this symptom cluster in Chinese BC patients and explore its impact on QoL.
Female adults currently receiving adjuvant chemotherapy for BC in two tertiary public hospitals in Xi’an, China were recruited in this study. Four validated measurements were used: Chinese version of Brief Fatigue Inventory, Pittsburgh Sleep Quality Index, Patient Health Questionnaire-Depression, and Functional Assessment of Cancer Therapy-Breast. Patient-rated outcomes were measured on day-8 of recently received chemotherapy via face-to-face or telephone call. Descriptive statistics, Spearman correlation and One way ANOVA were used in data analysis.
A total of 372 consented subjects with a mean age of 50.1±9.2 years completed the survey. Most of them were married, diagnosed with I-II stage BC, and undergone mastectomy. 99.2% of subjects experienced with fatigue, 87.4% were poor sleepers, while 93.3% had depressive symptom. The proportions of subjects who experiencing 0, 1, 2 and 3 symptoms were 0.8%, 3.0%, 11.8% and 84.4%, respectively. Spearman correlation analysis showed that fatigue, sleep disturbance and depression were significantly correlated with each other (RFS=.45, RFD=.57, RSD=.50, all P<0.001), and each of the single symptoms was negatively related to QoL (RFQ=-.57, RSQ=-.35, RDQ=-.60, all P<0.001). When using One way ANOVA to explore the influence of symptom cluster on QoL, we found that there was a significant (F = 34.76, P<0.001) decreasing trend in QoL across BC patients experiencing an increased number of symptoms (F-S-D).
The symptom cluster of F-S-D exists in most BC patients and it adversely affects their QoL.
Clinical trial identification
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All authors have declared no conflicts of interest.