Symptom Clusters in Brazilian Women With Stage I and Stage III Nonmetastatic Breast Cancer: A Cross-Sectional Study

IF 2 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Breast Journal Pub Date : 2026-03-01 DOI:10.1155/tbj/5427340

Luís Carlos Lopes-Júnior, Etreo Junior Carneiro da Silva Minarini, Raphael Manhães Pessanha, Luiz Cláudio Barreto Silva Neto, Naira Santos D’Agostini, Jonathan Grassi, Karla Anacleto Vasconcellos, Roberto Júnio Gomes Silva, Leticia Batista de Azevedo, Livia Machado Giacomin, Oscar Geovanny Enriquez-Martinez, Wesley Rocha Grippa

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引用次数: 0

Abstract

Background

Breast cancer is the most commonly diagnosed malignancy among women worldwide and a leading cause of cancer-related morbidity. As treatment advances have improved survival rates, symptom management has become a key component of comprehensive cancer care. Cancer-related symptoms often present in clusters rather than in isolation, potentially amplifying patient discomfort and negatively impacting quality of life. Identifying stage-specific symptom cluster patterns may provide critical insights for developing personalized supportive care strategies. This study aimed to identify and compare the prevalence, intensity, and discomfort of symptom clusters in women with Stage I and Stage III nonmetastatic breast cancer.

Method

This cross-sectional study included 87 women aged > 18 years with histopathological diagnoses of Stages I–III breast cancer, undergoing any phase of antineoplastic treatment at an oncology hospital in Brazil. Symptoms were assessed using the Memorial Symptom Assessment Scale (MSAS). The bootstrap resampling method was used to estimate 95% confidence intervals (CIs) for prevalence ratios (PRs) of MSAS symptoms, stratified by cancer stage. Symptom clusters were identified using hierarchical and k-means clustering analyses.

Results

Among Stage I patients, the most prevalent symptoms were pain (68.6%), worrying (62.8%), difficulty sleeping (62.8%), and fatigue (60.8%). In Stage III patients, the most frequent symptoms were pain (72.0%), fatigue (66.7%), worrying (63.9%), and dry mouth (50.0%). Stage I patients had a higher prevalence of difficulty concentrating (PR = 1.50; p = 0.015), shortness of breath (PR = 1.51; p < 0.001), feeling sad (PR = 1.41; p = 0.002), and hair loss (PR = 1.60; p = 0.037) compared to those with Stage III disease. Four clusters were identified for Stage I patients—neuropsychological, gastrointestinal, neurocognitive, and psychological—and for Stage III patients—psychoneurocognitive, gastrointestinal, chemotherapy-related, and neurocognitive.

Conclusion

These findings highlight the heterogeneity of symptom experiences in women with nonmetastatic breast cancer, with distinct cluster profiles emerging at different disease stages. Understanding stage-specific symptom patterns may inform more personalized and targeted supportive care strategies to improve quality of life and clinical outcomes in this population.

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巴西女性I期和III期非转移性乳腺癌的症状群：一项横断面研究

背景：乳腺癌是全世界女性中最常见的恶性肿瘤，也是癌症相关发病率的主要原因。随着治疗的进步提高了生存率，症状管理已成为综合癌症治疗的关键组成部分。癌症相关症状通常是聚集性的，而不是孤立的，这可能会加剧患者的不适，并对生活质量产生负面影响。确定特定阶段的症状集群模式可能为制定个性化的支持性护理策略提供关键见解。本研究旨在确定和比较I期和III期非转移性乳腺癌女性的患病率、强度和症状群的不适。方法：本横断面研究纳入87名年龄在bb0 - 18岁，组织病理学诊断为I-III期乳腺癌的女性，在巴西一家肿瘤医院接受任何阶段的抗肿瘤治疗。使用记忆症状评估量表（MSAS）评估症状。采用自举重采样方法估计按癌症分期分层的MSAS症状患病率（pr）的95%置信区间（ci）。使用分层和k-均值聚类分析确定症状聚类。结果：在I期患者中，最常见的症状是疼痛（68.6%）、焦虑（62.8%）、睡眠困难（62.8%）和疲劳（60.8%）。在III期患者中，最常见的症状是疼痛（72.0%）、疲劳（66.7%）、焦虑（63.9%）和口干（50.0%）。与III期患者相比，I期患者在集中注意力困难（PR = 1.50; p = 0.015）、呼吸短促（PR = 1.51; p < 0.001）、感觉悲伤（PR = 1.41; p = 0.002）和脱发（PR = 1.60; p = 0.037）方面的患病率更高。I期患者分为神经心理、胃肠道、神经认知和心理四类，III期患者分为心理神经认知、胃肠道、化疗相关和神经认知四类。结论：这些发现突出了非转移性乳腺癌女性症状经历的异质性，在不同的疾病阶段出现了不同的聚类特征。了解阶段特异性症状模式可以为更个性化和有针对性的支持性护理策略提供信息，以改善该人群的生活质量和临床结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Breast Journal 医学-妇产科学

CiteScore

4.00

自引率

0.00%

发文量

审稿时长

4-8 weeks

期刊介绍： The Breast Journal is the first comprehensive, multidisciplinary source devoted exclusively to all facets of research, diagnosis, and treatment of breast disease. The Breast Journal encompasses the latest news and technologies from the many medical specialties concerned with breast disease care in order to address the disease within the context of an integrated breast health care. This editorial philosophy recognizes the special social, sexual, and psychological considerations that distinguish cancer, and breast cancer in particular, from other serious diseases. Topics specifically within the scope of The Breast Journal include: Risk Factors Prevention Early Detection Diagnosis and Therapy Psychological Issues Quality of Life Biology of Breast Cancer.