Identifying psychosocial distress phenotypes in postoperative patients with breast cancer: A latent profile analysis.

Objective: This study aimed to identify psychosocial distress phenotypes in postoperative patients with breast cancer and explore influencing factors. Methods: A total of 210 patients were recruited from a general hospital in Guangzhou, China, between November 2022 and July 2023. Data were collected through a general information questionnaire, the Psychosocial Distress Questionnaire-Breast Cancer, and the Connor-Davidson Resilience Scale. Latent profile analysis was conducted to identify psychosocial distress phenotypes, followed by multinomial logistic regression to determine associated factors. Results: Three distinct phenotypes were identified: "Resilient-Latent Anxious-Somatic" (Class 1, 27%), "Anxious-Somatic Dominant" (Class 2, 51%), and "Anxious-Somatic with Financial Toxicity" (Class 3, 22%). Low resilience level (odds ratio [OR] ​= ​14.230, P ​< ​0.001; OR ​= ​51.931, P ​< ​0.001) and not undergoing breast reconstruction surgery (OR ​= ​4.645, P ​= ​0.006; OR ​= ​4.175, P ​= ​0.041) were risk factors for Class 2 and Class 3. Compared with Class 1, lower income (OR ​= ​3.127, P ​= ​0.009) and urban residence (OR ​= ​3.162, P ​= ​0.025) were risk factors for Class 2. Factors significantly associated with membership in Class 3 included older age (OR ​= ​0.923, P ​= ​0.008), unemployment (OR ​= ​3.181, P ​= ​0.047), being married (OR ​= ​16.993, P ​= ​0.010), and living with others (OR ​= ​0.071, P ​= ​0.033). Conclusions: Psychosocial distress among postoperative patients with breast cancer is heterogeneous, manifesting in three phenotypes shaped by diverse factors. Early identification of patients by phenotype and implementation of group-level interventions tailored to phenotype-specific characteristics are essential for mitigating psychosocial distress.