Symptom Experience and Management Needs of Breast Cancer Patients Undergoing Endocrine Therapy: A Qualitative Study.

Background: Endocrine therapy is essential for breast cancer management but often causes long-term side effects that impair quality of life. Understanding patients' lived experiences and unmet needs is critical for optimizing supportive care. Objective: To explore the symptom experiences, coping strategies, management challenges, and support needs of breast cancer patients undergoing endocrine therapy. Methods: A descriptive qualitative design was conducted in this study from December 2024 to May 2025. A purposeful sampling with the maximum variation strategy was adopted to select patients undergoing endocrine therapy for breast cancer. Semi-structured interviews were conducted to explore their symptom experiences, self-management practices and support needs. The data were analyzed using NVivo 12.0 through Braun and Clark's thematic analysis, and rigor was ensured through triangulation, participant validation, and audit trails. Results: A total of 20 female breast cancer patients receiving ≥6 months of endocrine therapy participated in this study. These data reveal four main themes and 13 sub-themes. Four themes emerged: (1) Substantial multidimensional disease burden, revealing synergistic physical symptoms and psychological distress driving social withdrawal; (2) Individual variations in symptom coping styles, categorizing strategies as adaptive (proactive lifestyle adjustments), defensive (avoidance), or creative (self-devised techniques); (3) Diverse symptom management dilemmas, including knowledge gaps, limited self-advocacy, inadequate social support, and diminished motivation; and (4) Personalized symptom management needs, emphasizing demands for tailored information, lifestyle guidance, psychological support, and digital health tools. Conclusion: Patients endure significant multidimensional symptoms exacerbated by heterogeneous coping capabilities and systemic barriers. Findings underscore an urgent need for patient-centered interventions addressing education, psychological care, and digital solutions to optimize long-term endocrine therapy management.