Purpose: Approximately 50% of cancer patients experience psychological distress; rates of fatigue and sleep disturbance range from 4 to 91%. Even though single symptoms have been well-described, there are few prospective studies of the co-occurrence of common symptoms including depression, fatigue and sleep disturbances, which may comprise a "cluster" in women with breast cancer. Therefore, further characterization and examination of this hypothesized symptom cluster in women with breast cancer is needed.

Method: These data are reported as part (N=30) of a clinical trial (R21CA106149) to test the effects of cranial electric stimulation on psychological distress, symptoms and immune parameters in women with breast cancer. Women newly diagnosed with breast cancer were enrolled and measures were collected prior to their first chemotherapy and prior to receiving the study intervention. Women currently on antidepressant medication were excluded. In conjunction with collection of serum samples, participants completed the Hospital Anxiety and Depression Scale (HADS), the Brief Fatigue Inventory (BFI), the Brief Pain Inventory (BPI) and the General Sleep Disturbance Scale (GSDS).

Findings: Scores on the HADS were elevated. 42% of participants scored > 8 on anxiety and 27% > 7 on depression. Similarly, scores on the BFI were elevated, but fewer met criteria for severe fatigue. Participants had moderate difficulty sleeping while pain was less severe than other symptoms.