Abstract
OBJECTIVE: This study aimed to identify upper-limb symptom clusters among breast cancer survivors and examine their associations with postoperative surgical complications. METHODS: In this cross-sectional study, women who underwent axillary lymph node dissection between January 2020 and December 2024 were evaluated using the Lymphedema Breast Cancer Questionnaire. Exploratory and confirmatory factor analyses were conducted to identify symptom clusters, and multiple linear regression analyses were used to assess associations between the identified clusters and surgical complications. RESULTS: A total of 768 women were included. Four symptom clusters were identified: scar-related symptom cluster (tightness, stiffness, and arm weakness), infection-related symptom cluster (high temperature, redness), lymphedema-related symptom cluster (heaviness, arm swelling), and paresthesia-related symptom cluster (aching, numbness). Wound dehiscence and seroma were significantly associated with the scar- and paresthesia-related symptom clusters; infection was significantly associated with the infection-related symptom cluster; and lymphedema and seroma were significantly associated with the lymphedema-related symptom cluster. CONCLUSIONS: Breast cancer survivors experienced distinct symptom clusters that were significantly associated with surgical complications. These findings highlight the importance of targeted prevention and management strategies, particularly for seroma, to reduce postoperative symptom burden.