Symptom Severity Subgroups and Individual Symptom-Associated Risk for Fear of Progression in Metastatic Breast Cancer

OBJECTIVES: To identify symptom severity subgroups among metastatic breast cancer survivors and examine their association with fear of progression. SAMPLE & SETTING: The sample included 102 individuals with metastatic breast cancer recruited during follow-up outpatient visits. METHODS & VARIABLES: A secondary analysis of symptom data was conducted to identify subgroups. Predominant symptoms were defined as the five most severe and prevalent within each subgroup. Logistic regression was used to identify predictors of fear of progression. RESULTS: Two symptom severity subgroups were identified: mild (n = 36, 35%) and severe (n = 66, 65%). Fatigue was the most prevalent symptom. Compared with the mild group, the severe group reported significantly higher breast cancer-specific symptom and fear-of-progression scores. Worry about worsening showed the strongest association with fear of progression (odds ratio = 2.9, p < 0.001). IMPLICATIONS FOR NURSING: Routine assessment of symptom severity and psychological distress is essential to identify survivors at risk for heightened fear of progression. Tailored nursing interventions may reduce fear of progression and improve quality of life.