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Presurgical symptom profiles predict quality of life 2 years after surgery in women with breast cancer

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Abstract

Purpose

Higher symptom burden in oncology patients is associated with poorer quality of life (QOL). However, the long-term predictive relationship between pre-treatment symptom profiles and QOL is unknown. The aim of this study was to identify subgroups of breast cancer patients based on their presurgical symptom profiles and to examine the predictive effect of group membership on QOL 2 years after surgery.

Methods

Data were analyzed from a longitudinal study of women’s (N = 198) symptoms after breast cancer surgery. Patient subgroups were identified by latent class analysis based on presurgical severity of five symptoms (i.e., attentional and physical fatigue, sleep disturbance, depression, and anxiety). Among these 198 women, quality of life 2 years after surgery was available for 97. Group differences in QOL were examined by general linear models.

Results

We identified four distinct patient groups. Group A (All Low) had low levels of all symptoms. Group B (Low Fatigue and Moderate Mood) was characterized by low attentional and physical fatigue but moderate sleep disturbance, depression, and anxiety. Group C (All Moderate) was characterized by moderate levels of all five symptoms. Group D was characterized by moderate attentional and physical fatigue and severe sleep disturbance, depression, and anxiety (Moderate Fatigue and High Mood). Group D had significantly lower overall QOL scores 2 years after surgery than Group A (p = 0.002).

Conclusions

Breast cancer patients’ presurgical symptom profile had a long-term predictive effect on QOL. Routine assessment of patients’ pre-treatment symptom is suggested to identify high risk group.

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Acknowledgments

This study was supported by a research grant to Dr. Mei-Ling Chen from the National Science Council of Taiwan (grant number: NSC 94–2314-B-182–025, NSC 95–2314-B-182–005, NSC 96–2628-B-182–032).

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

“All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.”

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Authors and Affiliations

  1. Graduate Institute of Nursing, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan, Taiwan

    Mei-Ling Chen

  2. Department of Nursing, Fu Jen Catholic University, New Taipei City, Taiwan

    Li-Ni Liu

  3. Department of Physiological Nursing, School of Nursing, University of California, San Francisco, CA, USA

    Christine Miaskowski

  4. Department of Surgery, Chang Gung Memorial Hospital and School of Medicine, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan

    Shin-Cheh Chen

  5. Department of Internal Medicine, Chang Gung Memorial Hospital and School of Medicine, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan

    Yung-Chang Lin

  6. Department of Rehabilitation Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan

    Jong-Shyan Wang

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  1. Mei-Ling Chen
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  2. Li-Ni Liu
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  3. Christine Miaskowski
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  4. Shin-Cheh Chen
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  6. Jong-Shyan Wang
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Correspondence to Mei-Ling Chen.

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Chen, ML., Liu, LN., Miaskowski, C. et al. Presurgical symptom profiles predict quality of life 2 years after surgery in women with breast cancer. Support Care Cancer 24, 243–251 (2016). https://doi.org/10.1007/s00520-015-2784-8

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  • DOI: https://doi.org/10.1007/s00520-015-2784-8

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