Abstract
Introduction: Identifying the pattern of change in symptoms is critical to effective symptom management. This study aimed to determine the trajectory of Main Chemotherapy-related Symptoms (MCRS) in breast cancer patients, explore the influencing factors of potential categories of MCRS trajectory.Methods: Patient-reported Outcomes Measurement System- breast-chemotherapy was used to measure the four highest incidence MCRS (pain, fatigue, anxiety, and depression) weekly in Breast cancer patients. The Growth Mixture Model (GMM) was used to fit the potential categories of the MCRS trajectory. Logistic regression was used to explore the influencing factors of potential categories of MCRS change trajectory.Results: 239 breast cancer patients completed the study. Fatigue and depression showed an overall upward trend during the chemotherapy cycle, while pain and anxiety showed a downward trend. There are two potential categories of anxiety trajectory, three potential categories of fatigue and pain trajectory, and four potential categories of depression trajectory. Compared with the mild-fatigue group, Patients in the moderate and high fatigue groups were more likely to be less educated, have lower household income, and be treated with anthracyclines. Compared with the mild-pain group, patients in the pain-declining and fluctuating-pain groups were young, live-alone, and treated with paclitaxel. Patients in the anxiety-rising group were younger, had premenopausal menstruation with regular monthly menstruation, and had stage II disease. Patients in the depression-rising and severe depression groups were more likely to be solitary and younger.Conclusion: The potential classes of major chemotherapy-related symptom trajectories vary in breast cancer patients. As for fatigue management, great attention should be paid to patients with low education, low family income, and anthracycline chemotherapy. For pain management, close attention should be paid to younger, solitary, and paclitaxel chemotherapy patients; For anxiety management, attention should be paid to younger patients with premenopausal menstruation and regular monthly menstruation patients, and those with stage II disease. In managing depression, attention should be paid to younger and solitary patients.
Synchronous bilateral breast cancer patients submitted to conservative treatment and brachytherapy – The experience of a service