Background: Women in treatment for breast cancer and undergoing chemotherapy often experience multiple chemotherapy-related adverse events simultaneously, making it essential for healthcare providers to pinpoint the core adverse event that can be targeted for more precise interventions.

Objective: To identify the core chemotherapy-related adverse events using network analysis in Chinese patients with breast cancer.

Methods: Data were collected from September 1, 2022, to November 30, 2022. Network analysis was used to construct an adverse events network. Node centrality was assessed using strength, closeness, and betweenness centralities. Comparisons of networks by different chemotherapy cycles were also made.

Results: A total of 195 patients were eligible for data analysis. In the overall network, fatigue (rS = 7.0612, rC = 0.0136, rB = 76) was the most central adverse event, followed by decreased appetite (rS = 6.8378, rC = 0.0124, rB = 42). In the comparison of networks by different chemotherapy cycles, muscle pain was the most central adverse event in the early phase of chemotherapy; fatigue was the most central adverse event in the middle phase of chemotherapy and remained the most central adverse event in the late phase of chemotherapy.

Conclusion: This study confirmed the core roles of fatigue and decreased appetite in chemotherapy-related adverse events in patients with breast cancer from patient-reported outcomes.

Implications for practice: Healthcare providers should focus their interventions on core adverse events to improve the efficiency of managing adverse events in patients with breast cancer undergoing chemotherapy.

Copyright © 2025 The Authors. Published by Wolters Kluwer Health, Inc.