Table 7. Summary of Symptom Clusters that Varied Across Time.

Symptom Cluster	Occurrence			Severity
	Symptom	Factor Loading		Symptom		Factor Loading
Time 1 – Prior to Surgery
Psychological/Cognitive/Sleep Symptom Cluster	Tension	0.435		Tension		0.977
	Anxiety	0.644		Anxiety		0.935
	Depression	0.463		Depression		0.733
	Difficulty concentrating	0.586		Difficulty concentrating		0.837
	Difficulty falling asleep	0.737		Difficulty falling asleep		0.655
	Fatigue or tiredness	0.535		Fatigue or tiredness		0.600
	Wake during the night	0.708		Wake during the night		0.535
	Waking too early	0.567		Waking too early		0.569
				Anger		0.713
				Forgetfulness		0.557
				Headache		0.411
				Impatience		0.754
				Irritability		0.729
				Mood swings		0.692
Irritability Symptom Cluster	Anger	0.778		Not Identified
	Impatience	0.738
	Irritability	0.797
	Mood swings	0.565
	Tension	0.566
Time 2 – 12 Months After Surgery
Sleep Symptom Cluster	Difficulty falling asleep	0.505		Difficulty falling asleep		0.518
	Wake during the night	0.822		Wake during the night		0.883
	Waking too early	0.966		Waking too early		0.891
Psychological/Cognitive Symptom Cluster	Anger	0.823		Not Identified
	Anxiety	0.913
	Depression	0.873
	Difficulty concentrating	0.687
	Fatigue or tiredness	0.510
	Forgetfulness	0.587
	Impatience	0.889
	Irritability	0.995
	Mood swings	0.795
	Tension	0.823
Psychological Symptom Cluster	Not Identified		Anger		0.881
			Anxiety		0.879
			Depression		0.706
			Impatience		0.793
			Irritability		0.946
			Mood swings		0.676
			Tension		0.724
Cognitive Symptom Cluster	Not Identified		Difficulty concentrating		0.678
			Fatigue or tiredness		0.420
			Forgetfulness		0.981
			Painful/tender breasts		0.411