Abstract

PurposeFatigue following breast cancer is a well-known problem, with both high and persistent prevalence. Previous studies suffer from lack of repeated measurements, late recruitment and short periods of follow-up. The course of fatigue from diagnosis and treatment to the long-time outcome status is unknown as well as differences in the level of fatigue between treatment regimens. The purpose of this study was to describe the long-time course of fatigue from the time of clinical suspicion of breast cancer, its dependence of patient characteristics and treatment regimens and the comparison with the course of fatigue among women with the same suspicion, but not diagnosed with breast cancer.MethodsThree hundred thirty-two women referred to acute or subacute mammography was followed with questionnaires from before the mammography and up to 1500 days. Fatigue was measured by the Multidimensional Fatigue Inventory (MFI-20). The women reported their initial level of fatigue before the mammography and thus without knowledge of whether they had cancer or not. Both women with and without cancer were followed. Women with cancer were identified in the clinical database established by Danish Breast Cancer Cooperative Group (DBCG) to collect information on treatment regimen.ResultsCompared to fatigue scores before diagnosis, women with breast cancer reported a large increase of fatigue, especially in the first 6 months, followed by a slow decrease over time. Despite the long follow-up period, the women with breast cancer did not return to their level of fatigue at time of the mammography. Women without breast cancer, experienced a rapid decrease of fatigue after disproval of diagnosis followed by a steadier period.ConclusionsFatigue is a persistent problem in women diagnosed with breast cancer, even several years following diagnosis and treatment. The women with breast cancer were most affected by fatigue in the first 6 months after diagnosis.

Highlights

  • Fatigue following breast cancer is a well-known and common problem, both during treatment and in the rehabilitation period

  • Despite the long follow-up period, the women with breast cancer did not return to their level of fatigue at time of the mammography

  • Fatigue is a persistent problem in women diagnosed with breast cancer, even several years following diagnosis and treatment

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Summary

Introduction

Fatigue following breast cancer is a well-known and common problem, both during treatment and in the rehabilitation period. The occurrence of fatigue ranges from 35% to almost all women in different studies [1, 2]. A large proportion of patients consider fatigue as their main problem [3,4,5,6,7,8] with large consequences for the women’s quality of life and rehabilitation. Fatigue is even suggested to be an independent marker of long-term survival without recidivism [9]. The pathways leading to fatigue following breast cancer are suggested to relate to the disease itself, to other diseases, to the treatment or to psychological reaction on the disease [2, Biering et al Journal of Patient-Reported Outcomes

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