Prevalence of physical problems detected by the distress thermometer and problem list in patients with breast cancer

Psychooncology. 2018 May;27(5):1394-1403. doi: 10.1002/pon.4631. Epub 2018 Feb 1.


Background: Patients with breast cancer have high rates of physical symptoms that negatively impact their quality of life. The relationship between women's perceptions of these physical symptoms and patient demographic and breast cancer characteristics is less well known. This study describes physical symptoms of patients with breast cancer and their relationship with patient characteristics.

Methods: Patients (n = 125) with breast cancer (stage 0-IV) completed questionnaires in a dedicated academic medical center breast cancer clinic. Patients reported demographics (age, race/ethnicity, marital status, and employment status) and disease characteristics (surgery type, receipt of chemotherapy, or antihormonal therapy). Patients reported whether they were bothered by any of the 22 physical problem list (PPL) variables from the distress thermometer and problem list.

Results: The median number of physical problems endorsed by patients was 3.0 (M = 3.43, SD = 3.42). Approximately one-fourth endorsed no physical symptoms while three-fourths reported at least 1 problem, and three-fifths endorsed 2 or more problems. Fatigue (40.0%), sleep (34.7%), skin dry/itchy (22.9%), pain (19.5%), and feeling swollen (19.5%) were most commonly reported. Age, race/ethnicity, marital status, employment status, and receipt of chemotherapy were associated with certain physical problems. Problems with breathing, eating, memory/concentration, nausea, and total number of endorsed PPL variables were associated with distress.

Conclusion: The breast cancer population demonstrates heavy physical symptom burden with multiple physical problems that are related to overall functioning. Special attention should be given to the physical symptom burden of younger, nonwhite, unmarried, and unemployed patients. Future research should investigate the PPL of the distress thermometer and problem list with other measures of symptom burden.

Keywords: breast cancer; distress thermometer and problem list; physical; physical problem list; symptom burden; symptoms.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Breast Neoplasms / complications*
  • Breast Neoplasms / psychology
  • Fatigue / epidemiology*
  • Fatigue / etiology
  • Female
  • Humans
  • Middle Aged
  • Nausea / epidemiology
  • Pain / epidemiology
  • Pain / etiology*
  • Physical Examination / methods
  • Prevalence
  • Quality of Life*
  • Sleep
  • Sleep Initiation and Maintenance Disorders / epidemiology*
  • Sleep Initiation and Maintenance Disorders / psychology
  • Socioeconomic Factors
  • Stress, Psychological / epidemiology*
  • Thermometers
  • Young Adult