Differences in symptom clusters before and twelve months after breast cancer surgery.
Melissa Mazor, Janine K Cataldo, Kathryn Lee and 9 others
PMID 29353634WHAT IT FOUND
Before surgery, menopausal symptoms grouped into irritability, pain, hormonal, and psychological/cognitive/sleep clusters.
At 12 months, pain and hormonal clusters persisted, while sleep symptoms separated from psychological and cognitive symptoms.
Key findings
01Pain/discomfort and hormonal clusters were identified at both time points and on both symptom dimensions.
02Before surgery, psychological, cognitive, and sleep symptoms grouped into one cluster.
03At 12 months, sleep symptoms formed a separate cluster.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study included only women scheduled for unilateral breast cancer surgery and excluded those with distant metastases. Most women had early-stage disease, so findings may not apply to advanced disease. The symptom measure focused on menopausal-related symptoms, so other common symptom clusters may have been missed. Some symptoms were excluded from the clustering analysis because their occurrence was too low or too high, so the clusters could differ if those symptoms were included. Symptoms were assessed only before and after surgery, not during treatment. Women who refused participation were often overwhelmed by the diagnosis, so the study may underestimate symptom burden. The sample was mostly White and well educated, which limits generalisability. Because no intervention was tested, it cannot show that treating a symptom cluster improves outcomes.
The easy way to misread this
Do not conclude that treating one symptom in a cluster will improve the others. This study described how symptoms grouped over time and did not test any treatment.