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Objective <p>To map the dynamic trajectory of quality of life (QoL) in newly diagnosed breast cancer patients and identify the central symptom drivers that precipitate global health decline during the peri-treatment period.</p> Methods <p>In this longitudinal study, patients newly diagnosed with breast cancer (<i>n</i> = 337) were recruited at a comprehensive cancer center in Guangzhou, China. The EORTC QLQ-C30 was administered at diagnosis (T1), discharge (T2), and one-month post-discharge (T3). We utilized Cross-Lagged Panel Network (CLPN) analysis to determine temporal relationships and identify influential “bridge” nodes between time points.</p> Results <p>Symptom burden shifted significantly over time; insomnia was dominant at diagnosis, whereas fatigue peaked post-discharge. Network analysis revealed two distinct driver mechanisms. During the transition from diagnosis to treatment (T1–T2), Cognitive Functioning emerged as the strongest predictor of subsequent symptom deterioration (Out-Expected Influence [EI] = 0.366). Conversely, in the acute recovery phase (T2–T3), Nausea/Vomiting replaced cognitive issues as the central driver (Out-EI = 0.517), acting as the primary gateway to global health decline.</p> Conclusion <p>The drivers of QoL deterioration evolve rapidly during the peri-treatment phase. Cognitive dysfunction at diagnosis serves as an early temporal predictor for somatic symptoms, suggesting that clinical management must shift from reactive symptom control to proactive cognitive prehabilitation at the point of diagnosis.</p>

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Cognitive functioning and nausea as stage-specific drivers of quality of life in breast cancer: a longitudinal network analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月7日

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  • Furong Chen,
  • Jinxian Feng,
  • Min Xu,
  • Shaoxue Li,
  • Yuen-Shan Ho,
  • Naomi Takemura,
  • Janelle Yorke,
  • Jiaying Li,
  • Zengjie Ye

摘要

Objective

To map the dynamic trajectory of quality of life (QoL) in newly diagnosed breast cancer patients and identify the central symptom drivers that precipitate global health decline during the peri-treatment period.

Methods

In this longitudinal study, patients newly diagnosed with breast cancer (n = 337) were recruited at a comprehensive cancer center in Guangzhou, China. The EORTC QLQ-C30 was administered at diagnosis (T1), discharge (T2), and one-month post-discharge (T3). We utilized Cross-Lagged Panel Network (CLPN) analysis to determine temporal relationships and identify influential “bridge” nodes between time points.

Results

Symptom burden shifted significantly over time; insomnia was dominant at diagnosis, whereas fatigue peaked post-discharge. Network analysis revealed two distinct driver mechanisms. During the transition from diagnosis to treatment (T1–T2), Cognitive Functioning emerged as the strongest predictor of subsequent symptom deterioration (Out-Expected Influence [EI] = 0.366). Conversely, in the acute recovery phase (T2–T3), Nausea/Vomiting replaced cognitive issues as the central driver (Out-EI = 0.517), acting as the primary gateway to global health decline.

Conclusion

The drivers of QoL deterioration evolve rapidly during the peri-treatment phase. Cognitive dysfunction at diagnosis serves as an early temporal predictor for somatic symptoms, suggesting that clinical management must shift from reactive symptom control to proactive cognitive prehabilitation at the point of diagnosis.