Symptom phenotypes and their associations with fear of cancer recurrence and social support among breast cancer patients: a latent profile analysis

To identify symptom phenotypes among breast cancer survivors using latent profile analysis (LPA) and examine differences in fear of cancer recurrence (FCR) and social support levels across phenotypes. A multicenter cross-sectional study recruited 357 breast cancer survivors through convenience sampling from three university-affiliated tertiary hospitals in Beijing between November 2024 and January 2025. Symptoms were assessed using the Memorial Symptom Assessment Scale (MSAS), while the Fear of Cancer Recurrence Inventory–Short Form and Social Support Rating Scale measured FCR severity and perceived social support. LPA was performed using severity scores of nine MSAS symptoms to determine the optimal symptom profile model. Three symptom phenotypes were identified: Emotion-reactive (33.9%), Somatic-burden fatigue–pain (13.2%), and Regulated low-symptom (52.9%). Significant differences among these phenotypes were observed in medical burden, treatment method, activities of daily living, and illness cognition ( P < 0.05). FCR levels were significantly higher in the Emotion-reactive and Somatic-burden phenotypes compared with the Regulated low-symptom phenotype ( p < 0.001, η 2 p = 0.199), with no difference between the two high-symptom phenotypes. After adjusting for covariates, differences in perceived social support across symptom phenotypes were not significant ( p = 0.119, η 2 p = 0.012). Breast cancer survivors exhibit substantial heterogeneity in symptom phenotypes: those with Emotion-reactive and Somatic-burden fatigue–pain phenotypes experience higher FCR levels, whereas individuals with the Regulated low-symptom phenotype show better symptom control and comparatively lower FCR levels. Integrating symptom phenotypes with FCR may aid rapid identification of high-risk subgroups and support precision nursing in survivorship care.