Document Type

Capstone Experience

Graduation Date


Degree Name

Master of Public Health



First Committee Member

Dr. Tricia D LeVan

Second Committee Member

Dr. Ann Berger

Third Committee Member

Dr. Jane Meza


Context. Breast cancer patients experience multiple concurrent symptoms before and after chemotherapy (CTX). Physical and psychological symptoms may persist after treatment and reduce the quality of life (QOL) of survivors.

Objectives. Identify differences in prevalence and severity of symptoms at three times within 1- year of starting CTX; and identify symptom cluster and QOL trajectories over these times in breast cancer patients.

Methods. Symptoms were identified in breast cancer patients (N=219) before the start of CTX (baseline), 30 days after the last CTX, and 1-year after the first CTX. Hospital Anxiety and Depression Scale and Symptom Experience Scale measured symptoms. The MOS-SF-36v2 questionnaire measured QOL. Exploratory factor analysis (EFA) was performed to identify symptom clusters at each time, then clusters were compared over time.

Results. The prevalence and severity of 10 symptoms gradually decreased over time (p

Conclusions. Symptoms improved over time from baseline to 1 year. Symptom experience appears to be dynamic and symptom clusters differed over time. Despite these symptoms, women reported QOL similar to population norms 1-year after the first CTX treatment.