Symptom clusters experienced by breast cancer patients at various treatment stages: a systematic review
Open accessAbstract
Breast cancer patients often experience symptoms that adversely affect their quality of life. It is understood that many of these symptoms tend to cluster together: while they might have different manifestations and occur during different phases of the disease trajectory, the symptoms often have a common aetiology that is a potential target for intervention. Understanding the symptom clusters associated with breast cancer might usefully inform the development of effective care plans for affected patients. The aim of this paper is to provide an updated systematic review of the known symptom clusters among breast cancer patients during and/or after cancer treatment. A search was conducted using five databases for studies reporting symptom clusters among breast cancer patients. The search yielded 32 studies for inclusion. The findings suggest that fatigue-sleep disturbance and psychological symptom cluster (including anxiety, depression, nervousness, irritability, sadness, worry) are the most commonly-reported symptom clusters among breast cancer patients. Further, the composition of symptom clusters tends to change across various stages of cancer treatment. While this review identified some commonalities, the different methodologies used to identify symptom clusters resulted in inconsistencies in symptom cluster identification. It would be useful if future studies could separately examine the symptom clusters that occur in breast cancer patients undergoing a particular treatment type, and use standardised instruments across studies to assess symptoms. The review concludes that further studies could usefully determine the biological pathways associated with various symptom clusters, which would inform the development of effective and efficient symptom management strategies.
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Symptoms such as fatigue, depression, anxiety, and insomnia commonly co-occur across the cancer treatment and survivorship trajectory and may have shared roots such as inflammation.
“Commonly co-occurring across the cancer treatment and survivorship trajectory (118), symptoms such as fatigue, depression, anxiety, and insomnia may have shared roots, such as inflammation (18).”
From Interventions for insomnia in cancer patients and survivors-a comprehensive systematic review and meta-analysis (2024) · cites this paper as [118]
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- Authors
- So, W. K. W., Law, B. M. H., Ng, M. S. N., He, X., Chan, D. N. S., Chan, C. W. H., & McCarthy, A. L.
- Affiliations
- Chinese University of Hong Kong (HK)
- Mater Health Services (AU)
- Corresponding author
- So, Winnie K. W.
- ORCID
- Venue
- Cancer Medicine
- Publisher
- Wiley
- Published
- 2021-03-21
- Volume
- 10
- Issue
- 8
- Pages
- 2531-2565
- ISSN
- 2045-7634 (ISSN-L)
- PMC
- PMC8026944
- OpenAlex
- W3139406911
- Cited by
- 181
- References
- 71
- Citations by year
- 2026: 39 · 2025: 48 · 2024: 43 · 2023: 31 · 2022: 14 · 2021: 5
- FWCI
- 2.82
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Cancer Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Griffith Research Online (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Keywords
- breast cancer, symptom clusters, fatigue, sleep disorders, psychological symptoms, anxiety, depression, quality of life, symptom management
- MeSH terms
- Breast Neoplasms, Depression, Fatigue, Female, Humans, Psychometrics, Sleep Wake Disorders, Symptom Assessment
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