Objective To explore the symptoms and symptom cluster composition during chemotherapy in breast cancer patients and to provide a basis for symptom management during chemotherapy in breast cancer patients. Method A total of 210 breast cancer patients admitted to Hefei Cancer Hospital Chinese Academy of Sciences from May 2023 to August 2024 were selected and basic information questionnaire and Chinese version of Memory Symptom Assessment Scale were used to conduct questionnaire surveys in the first cycle of chemotherapy T1 the second cycle of chemotherapy T2 the third cycle of chemotherapy T3 and the last cycle of chemotherapy T4 respectively. Questionnaire symptom clusters were extracted using exploratory factor analysis. Result Initially 210 breast cancer patients met the inclusion criteria. At the T1 T2 T3 T4 time points 210 205 199 and 192 breast cancer patients participated in the follow-up respectively. The number of symptoms at each time node from T1 to T4 was 9 6 14 11 7 16 12 8 18 and 11 6 16 respectively. The number of symptoms with an incidence rate of greater than 20% at each time node from T1 to T4 was 15 20 20 and 16 respectively. Three common factors were extracted from T1 including gastrointestinal symptom cluster emotional and psychological symptom cluster and menopausal symptom cluster. Five common factors were extracted from T2 to T3 including gastrointestinal symptom cluster emotional and psychological symptom cluster neurological symptom cluster menopausal symptom cluster and self - image disorder symptom cluster. Four common factors were extracted at T4 including gastrointestinal symptom cluster emotional and psychological symptom cluster neurological symptom cluster and menopausal symptom cluster.Conclusion Breast cancer patients receiving adjuvant chemotherapy experience multiple symptoms and different symptom clusters during different cycles of chemotherapy. Clinical staff should pay attention to the symptom clusters of breast cancer patients during chemotherapy and take appropriate measures to actively intervene to alleviate multiple symptoms thereby reducing the impact of symptom clusters on patients.