Identification of subgroups of self-reported outcomes among breast cancer patients undergoing surgery and chemotherapy: A cross-sectional study

Abstract

Objectives: To identify the subgroups of self-reported outcomes and associated factors among breast cancer patients undergoing surgery and chemotherapy. Methods: A cross-sectional study was conducted between January and November 2021. We recruited patients from two tertiary hospitals in Shanghai, China, using convenience sampling during their hospitalization. Patients were assessed using a questionnaire that included sociodemographic and clinical characteristics, the Patient Reported Outcomes Measurement Information System profile-29 (PROMIS-29), and the PROMIS-cognitive function short form 4a. Latent class analysis was performed to examine possible classes regarding self-reported outcomes. Multiple logistic regression analysis was used to determine the associated factors. Analysis of variance (ANOVA) was conducted for symptoms across the different classes. Results: A total of 640 patients participated in this study. The findings revealed three subgroups in terms of self-reported outcomes among breast cancer patients undergoing surgery and chemotherapy: low physical-social-cognitive function, high physical-low cognitive function, and high physical-social-cognitive function. Multivariable logistic regression analysis showed that age (≥ 60 years old), menopause, the third chemotherapy cycle, undergoing simple mastectomy and breast reconstruction, duration of disease 3–12 months, stage III/IV cancer, and severe pain were associated factors of the functional decline groups. Besides, significant differences in depression and sleep disorders were observed among the three groups. Conclusions: Breast cancer patients receiving surgery and chemotherapy can be divided into three subgroups. Aging, menopause, chemotherapy cycle, surgery type, duration and stage of disease, and severe pain affected the functional decline groups. Consequently, healthcare professionals should make tailored interventions to address the specific functional rehabilitation and symptom relief needs.

Keywords

• Breast neoplasms
• Latent class analysis
• Function
• Surgery
• Chemotherapy