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.

After axillary lymphadenectomy (ALND) or radiotherapy for breast cancer or malignant melanoma, damage to the lymphatic tissue can reduce the lymphatic transport capacity and increase interstitial fluid accumulation. This can lead to swelling, pain, progressive trophic skin changes and an elevated risk of infections. Moreover, functional impairment of the affected limb can result in significant psychosocial consequences. Affected patients are usually informed about their increased lifetime risk of developing lymphedema and current guidelines from numerous international and national societies recommend that ipsilateral medical interventions, such as vascular punctures for blood sampling or blood pressure measurements should be avoided. If contralateral venous access is difficult, suboptimal puncture sites such as the foot are chosen or a central venous catheter is placed, even though this is associated with limited access and reduced visualization of the puncture site. Unsuccessful venipuncture attempts can cause pain, discomfort and functional limitations; in particular, placing peripheral intravenous catheters at suboptimal sites such as the foot can substantially impair mobility and thus increase the risk of complications such as deep vein thrombosis. Until recently, evidence on ipsilateral procedures was scarce and largely derived from small case studies; however, emerging data indicate that isolated procedures such as venous puncture and catheter placement can be safely performed following ALND or axillary radiotherapy in the absence of pre-existing lymphedema. Likewise, noninvasive methods (e.g., blood pressure measurements) do not appear to elevate the risk of lymphedema, although ipsilateral interventions should remain contraindicated in patients with established lymphedema. Thus, following an unsuccessful contralateral puncture, an ipsilateral puncture should be considered before selecting unfavorable puncture sites or considering the placement of a central venous catheter.