Khan Farzana, Ahmad Nezamuddin, Biswas Fazle Noor
Department of Palliative Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
Indian J Palliat Care. 2018 Oct-Dec;24(4):397-401. doi: 10.4103/IJPC.IJPC_77_18.
Breast cancer (BC) patients may experience multiple symptoms due to the disease itself, cancer treatment or combination of both.
The aim of the present study was to express multiple symptoms experienced by the patients with BC as clusters.
This was a retrospective study. We examined symptom profiles of 120 patients with BC who attended the Centre for Palliative Care, Bangabandhu Sheikh Mujib Medical University in Dhaka, Bangladesh, from January 2009 to December 2013. We included all case sheets of BC patients, which had documentation of needed information. Following symptoms were analyzed: pain, nausea, loss of appetite, constipation, weakness, cough, breathlessness, sleeplessness, lymphedema, sadness, anxiety, and depression. Hierarchical cluster analysis was used to identify the natural groupings within the set.
We could identify three clusters, namely (1) "neuropsychiatric," (2) "gastro-respiratory," and (3) "miscellaneous" symptom clusters. The symptoms in cluster 2 comprised of cough, breathlessness, nausea, and constipation. Cluster 1 was characterized by pain, depression, anxiety, weakness, sleeplessness, and loss of appetite. Cluster 2 was comprised of cough, breathlessness, nausea, and constipation. Cluster 3 consisted of two symptoms lymphedema and sadness. The results revealed that the multiple symptoms of patients with BC experienced had been clustered together. Neuropsychiatric symptoms and weakness formed a significant strong relationship with each other.
Knowledge obtained from this study could be beneficial for better understanding, assessment, and management of symptom clusters in women with BC. It may also help patients to plan ahead for them to seek management of concurrent symptoms to improve their quality of life.
乳腺癌（BC）患者可能因疾病本身、癌症治疗或两者兼而有之而出现多种症状。
本研究的目的是将BC患者经历的多种症状表达为聚类。
这是一项回顾性研究。我们检查了2009年1月至2013年12月期间在孟加拉国达卡的班加班杜·谢赫·穆吉布医科大学姑息治疗中心就诊的120例BC患者的症状特征。我们纳入了所有有所需信息记录的BC患者病历。分析了以下症状：疼痛、恶心、食欲不振、便秘、虚弱、咳嗽、呼吸急促、失眠、淋巴水肿、悲伤、焦虑和抑郁。采用层次聚类分析来识别数据集中的自然分组。
我们可以识别出三个聚类，即（1）“神经精神性”，（2）“胃肠 - 呼吸性”，和（3）“其他”症状聚类。聚类2中的症状包括咳嗽、呼吸急促、恶心和便秘。聚类1的特征是疼痛、抑郁、焦虑、虚弱、失眠和食欲不振。聚类2由咳嗽、呼吸急促、恶心和便秘组成。聚类3由淋巴水肿和悲伤这两种症状组成。结果显示，BC患者经历的多种症状已被聚类在一起。神经精神症状和虚弱彼此之间形成了显著的强关系。
从本研究中获得的知识可能有助于更好地理解、评估和管理BC女性患者的症状聚类。它还可能帮助患者提前规划，以便寻求并发症状的管理，从而提高他们的生活质量。
