西班牙裔乳腺癌幸存者的淋巴水肿症状负担模式与癌症复发担忧：潜在剖面分析

Background: Breast cancer survivors often experience persistent physical and psychosocial challenges, including lymphedema symptoms and unmet supportive care needs. Previous studies have noted that the simultaneous occurring of these burdens may compound their effects on psychological stress, such as recurrence worry. Hispanic populations may face unique survivorship challenges that limit access to healthcare and support. Objective: This study examined latent profiles of burden from lymphedema symptoms and unmet support needs, and differences in recurrence worry across these profiles within Hispanic women with breast cancer. Methods: Hispanic women aged 20 and older, previously diagnosed with breast cancer in Central Florida, were for a population-based study examining health-related quality of life from September 2023 to October 2025. Five lymphedema symptoms (pain, swelling, movement, numbness, stiffness) were assessed using the FACT-B+4 scale. The strength of 5 unmet need domains (information needs, care needs, quality of life needs, psychological needs, and practical needs) was assessed using the 35-item Cancer Survivors' Unmet Needs questionnaire. Latent profile analysis was conducted to identify the distinct latent burden patterns, and model performance was evaluated with BIC, AIC, and entropy. Multivariable linear regression compared differences in recurrence worry (frequency, mood impact, daily function interference), measured by the 3-item Lerman Breast Cancer Worry Scale, across the identified profiles. Results: A total of 564 breast cancer survivors (mean age: 58.9 ± 11.9 years; mean time since diagnosis: 4.1 ± 2.0 years) were included in the latent profile analysis. The five-profile model was selected as the optimal model. The five distinct profiles include low symptoms and moderate needs (Profile 1: n = 72, 12.8%), high symptoms and moderate needs (Profile 2: n = 52, 9.2%), high symptoms and strong needs (Profile 3: n = 34, 6.0%), low symptom and low needs (Profile 4: n = 303, 53.7%), and moderate symptoms but low needs (Profile 5: n = 103, 18.3%). Profiles differed significantly in recurrence worry frequency, mood impact, daily activity interference (all p < 0.001). Survivors in Profiles 1, 2, and 3 reported more frequent worry, higher impact on mood, and higher interference with daily functioning than those in Profiles 4 and 5. Conclusions: Distinct burden profiles highlight heterogeneity in the survivorship experience of Hispanic women with breast cancer. Particularly, survivors with moderate or strong unmet needs reported elevated recurrence worry. Investigating the barriers to symptom management and the strategies to address unmet support needs is crucial to reducing psychological stress and enhancing the quality of life among breast cancer survivors. Funding: Florida Breast Cancer Foundation.