Biological research for nursing
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This study aimed to (1) identify subgroups of women with breast cancer with the psychological symptom cluster (fatigue, depressive symptoms, and anxiety) during the first 18 months of adjuvant therapy and (2) explore associations between demographic and clinical characteristics and variations in genetic polymorphisms related to hypothalamic-pituitary-adrenal (HPA) axis function and predicted symptom trajectory subgroup membership. We obtained symptom data at 4 time points from baseline to 18 months of adjuvant therapy among 292 postmenopausal women with breast cancer. Genetic data were collected in a subgroup at baseline (N = 184). ⋯ Women who were younger, less educated, and who received chemotherapy had greater likelihood of being in the high-symptom subgroup. Variation in genes regulating the HPA axis (FKBP5 rs9394309 [odds ratio (OR) = 3.98, p = .015], NR3C2 rs5525 [OR = 2.54, p = .036], and CRHR1 rs12944712 [OR = 3.99, p = .021]) was associated with membership in the high-symptom subgroup. These results may help to identify women with breast cancer who are at increased risk for psychological symptoms, facilitating the development of individualized and preemptive interventions to better manage these symptoms during adjuvant therapy.