Supportive Care in Cancer

, Volume 22, Issue 3, pp 635–644 | Cite as

The evolution of supportive care needs trajectories in women with advanced breast cancer during the 12 months following diagnosis

  • Wendy W. T. LamEmail author
  • Janice Tsang
  • Winnie Yeo
  • Joyce Suen
  • Wing Ming Ho
  • Tze Kok Yau
  • Inda Soong
  • Ka Yan Wong
  • Ava Kwong
  • Dacita Suen
  • Wing Kin Sze
  • Alice W. Y. Ng
  • Afaf Girgis
  • Richard Fielding
Original Article



This longitudinal study examined if the evolution of supportive care needs differed over the first year following the diagnosis of advanced breast cancer and examined factors differentiating these trajectories.


Two hundred twenty-eight of 276 Chinese women with advanced breast cancer were assessed while they were awaiting or receiving initial chemotherapy, then again at 6 weeks, 3 months, 6 months, and 12 months post-baseline. Supportive care needs (SCNS-34-Ch), psychological distress (Hospital Anxiety and Depression scale), symptom distress (MSAS-Ch), and patient satisfaction (PSEQ-9) were assessed at baseline; supportive care needs were reassessed at each follow-up assessment. Latent growth mixture modeling explored if trajectories differed within each of four need domains: health system, information, and patient support (HSIPS); psychological; physical daily living (PDL); and sexuality needs. Logistic regression identified factors predicting trajectory patterns.


Two distinct trajectories were identified for HSIPS and sexuality need domains and three distinct trajectories for psychological and physical daily living need domains. Most women showed stable low levels of HSIPS (78.9 %), psychological (82.4 %), PDL (83.7 %), and sexuality (97.4 %) supportive care needs. One in five and one in eight women showed high initial supportive care needs in HSIPS and psychological and PDL domains, respectively. With the exception of sexuality needs, trajectory patterns were predicted by physical symptom distress. Women in the high-decline group reported greater physical symptom distress.


Most Chinese women with advanced breast cancer showed low stable supportive care needs. Physical symptom distress predicted high supportive care needs. Interventions should focus on optimizing symptom assessment and management.


Supportive care needs Trajectory patterns Advanced breast cancer Chinese 



The authors would like to thank our research assistants for the contributions of the data collection and management, and to the women who participated in the study. This work was supported by a grant from the Hong Kong Cancer Fund and a grant from the Seed Funding Programme for Basic Research by The University of Hong Kong.

Conflict of interest

The authors declare no conflicts of interest.

Supplementary material

520_2013_2018_MOESM1_ESM.doc (234 kb)
ESM 1 (DOC 234 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Wendy W. T. Lam
    • 1
    Email author
  • Janice Tsang
    • 2
  • Winnie Yeo
    • 3
  • Joyce Suen
    • 3
  • Wing Ming Ho
    • 3
  • Tze Kok Yau
    • 4
  • Inda Soong
    • 4
  • Ka Yan Wong
    • 5
  • Ava Kwong
    • 6
  • Dacita Suen
    • 6
  • Wing Kin Sze
    • 7
  • Alice W. Y. Ng
    • 7
  • Afaf Girgis
    • 8
  • Richard Fielding
    • 1
  1. 1.Centre for Psycho-Oncology Research and Training, Division of Behavioural Health, School of Public HealthThe University of Hong KongPokulamHong Kong
  2. 2.Department of Clinical OncologyThe University of Hong KongPokulamHong Kong
  3. 3.Department of Clinical OncologyThe Chinese University of Hong KongShatinHong Kong
  4. 4.Department of Clinical OncologyPamela Youde Nethersole Eastern HospitalChai WanHong Kong
  5. 5.Department of OncologyPrincess Margaret HospitalHong KongHong Kong
  6. 6.Department of SurgeryThe University of Hong KongPokulamHong Kong
  7. 7.Department of Clinical OncologyTuen Mun HospitalTuen MunHong Kong
  8. 8.Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW MedicineUniversity of New South WalesSydneyAustralia

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