Supportive Care in Cancer

, Volume 24, Issue 1, pp 357–366 | Cite as

Identifying trajectory clusters in breast cancer survivors’ supportive care needs, psychosocial difficulties, and resources from the completion of primary treatment to 8 months later

  • A. Brédart
  • O. Merdy
  • B. Sigal-Zafrani
  • C. Fiszer
  • S. Dolbeault
  • J-B. Hardouin
Original Article



This study aimed to chart patterns of simultaneous trajectories over 8 months in breast cancer survivors’ (BCS) supportive care needs, psychological distress, social support, and posttraumatic growth. Clusters of BCS among these trajectories were identified and characterized.


Of 426 BCS study participants, 277 (65 %) provided full assessments in the last week of primary cancer treatment and 4 and 8 months later. Latent trajectories were obtained using growth mixture modeling for patients who responded to all scores for at least one time point (n = 348). Then, classification of BCS was performed by hierarchical agglomerative clustering on axes derived from a multiple factor analysis of trajectory assignments. Self-esteem, attachment security, and satisfaction with care were assessed at baseline.


Four trajectory clusters were identified, including two BCS subgroups (63 %) with low needs and low psychological distress. Two others (37 %) exhibited high or increasing needs and concerning levels of psychological distress. These latter clusters were characterized by higher insecure attachment, lower satisfaction with care, and either lower education or younger age, and having undergone chemotherapy.


More than a third of BCS present unfavorable patterns in supportive care needs over 8 months after primary cancer treatment. Identified psychosocial and cancer care characteristics point to targets for enhanced BCS supportive care.


Breast neoplasms Patient care management Longitudinal studies Trajectory Cluster analysis Supportive care needs 



This study is granted by the French National Cancer League and the French Ile-de-France region Cancerpole. The authors wish to acknowledge the assistance of Gariné Catanasian, Catherine Gravigny, Marie Jézéquel, and Sophie Simandoux for their assistance in recruiting patients. We thank Leslie Elliott for her linguistic revision of the manuscript.

Conflict of interest

The authors have declared no conflict of interest.

Supplementary material

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ESM 1 (DOCX 34 kb)
520_2015_2799_MOESM2_ESM.doc (119 kb)
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520_2015_2799_MOESM3_ESM.docx (487 kb)
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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • A. Brédart
    • 1
    • 2
  • O. Merdy
    • 3
    • 8
  • B. Sigal-Zafrani
    • 7
  • C. Fiszer
    • 1
    • 2
  • S. Dolbeault
    • 1
    • 4
    • 5
  • J-B. Hardouin
    • 3
    • 6
  1. 1.Psycho-Oncology Unit, Supportive Care DepartmentInstitute CurieParis Cedex 05France
  2. 2.Psychology Institute, LPPS EA 4057University Paris DescartesBoulogne BillancourtFrance
  3. 3.EA 4275, Biostatistics, Pharmacoepidemiology and Subjective Measures in Health SciencesUniversity of NantesNantesFrance
  4. 4.Inserm, U 669ParisFrance
  5. 5.University Paris-Sud and UMR-S0669University Paris DescartesParisFrance
  6. 6.Unit of Methodology and BiostatisticsUniversity Hospital of NantesNantesFrance
  7. 7.Tumor Biology DepartmentInstitut CurieParisFrance
  8. 8.Institute of High School in OsteopathyLaboratory of Osteopathy ResearchNantesFrance

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