title: The course of severe fatigue in disease-free breast cancer patients: a longitudinal study.
abstract: BACKGROUND
  We investigated whether fatigue is a persistent problem, and whether persistent fatigue is related to former treatment modalities. In addition, we studied the predictors of persistent fatigue.
  
  
  METHODS
  At baseline (n=150, mean time since cancer treatment=29 months) patients were asked to fill out several questionnaires on psychological, physical, social, cognitive and behavioral aspects (Ann. Oncol. 2002;13:589-598). During the 2 years after baseline patients were asked to fill out monthly a fatigue questionnaire (CIS-fatigue). Hundred-twenty-one patients completed the study, 10 dropped out and 19 had a disease recurrence.
  
  
  RESULTS
  Twenty-four percent of the patients experienced persistent severe fatigue complaints during the 2-year observation period. Persistent fatigue seemed to be related to the duration of former treatment but unrelated to type of surgery, type of adjuvant therapy and time since treatment finished. High anxiety, high impairment in role functioning and low sense of control over fatigue symptoms at baseline were predictors of persistent fatigue.
  
  
  CONCLUSIONS
  Fatigue appears to be a persistent problem for a quarter of a sample of disease-free breast cancer patients during a 2-year period. The predictors of persistent fatigue found in this study can be helpful for the development of interventions to reduce post-treatment fatigue.
authors.affiliation: Department of Medical Psychology, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
authors.forename: P
authors.initials: P
authors.lastname: Servaes
authors.forename: M F M
authors.initials: MF
authors.lastname: Gielissen
authors.forename: S
authors.initials: S
authors.lastname: Verhagen
authors.forename: G
authors.initials: G
authors.lastname: Bleijenberg
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000453:epidemiology*; D003071:Cognition; D018572:Disease-Free Survival; D005221:Fatigue / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009483:Neuropsychological Tests; D011788:Quality of Life / Q000523:psychology; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires