Objective To investigate the composition and incidence of chemotherapy-related symptom clusters in breast cancer patients, construct a symptom network for breast cancer patients, and identify core symptoms within the network.

Methods A convenient sampling method was used to select 234 breast cancer patients as survey subjects. The current status of symptom occurrence was investigated using the Anderson Symptom Assessment Scale. Symptom clusters were extracted using exploratory factor analysis, and the symptom network was constructed using software R.

Results The four symptoms with the highest incidence during chemotherapy in breast cancer patients were fatigue (88.9%), forgetfulness (82.4%), dry mouth (81.2%), and distress (75.2%); there were four symptom clusters: gastrointestinal symptoms (including nausea, vomiting, fatigue, poor appetite, dry mouth, and somnolence), sleep-related symptoms (including forgetfulness and disturbed sleep), emotional symptoms (including distress and sadness), and numbness-related symptoms (including numbness and pain). In the symptom cluster network, the strongest symptoms within each cluster were nausea (r_s = 1.16), disturbed sleep (r_s = 0.70), distress (r_s = 0.86), and pain (r_s = 0.55).

Conclusions The core symptoms within the breast cancer chemotherapy-related symptom clusters are nausea, disturbed sleep, distress, and pain. It is recommended that clinical nursing staff develop intervention plans based on these core symptoms as targets for symptom cluster intervention, to improve the precision and efficiency of symptom management.