title: A comparison of the characteristics of disease-free breast cancer survivors with or without cancer-related fatigue syndrome.
abstract: OBJECTIVE
  To determine the prevalence of cancer-related fatigue syndrome (CRFS) in a population of disease-free breast cancer survivors and to investigate the relationship between CRFS and clinical variables.
  
  
  METHODS
  Women (200) were recruited. All participants were between 3 months and 2 years after completion of primary therapy for breast cancer and were disease free. Subjects completed a diagnostic interview for CRFS and structured psychiatric interview. Participants also completed quality of life, mood and fatigue questionnaires, and provided a blood sample for haematological and biochemical analysis and a 24-h urine specimen for cortisol estimation. Subjects wore a wrist actigraph for 7 days to measure activity and sleep.
  
  
  RESULTS
  Sixty women (30% of participants) were found to fulfil the criteria for CRFS. There were statistically significant differences between fatigued and non-fatigued women with respect to fatigue severity (p<0.01), mood (p<0.01) and quality of life scores (p<0.05). There were significant differences in blood variables including raised total white cell count and lower sodium (all p<0.02). There was no difference in the 24h urinary free cortisol levels. Actigraphic data demonstrated significant differences in sleep quality and disturbance, but not in overall levels of daytime activity or circadian rhythm.
  
  
  CONCLUSIONS
  CRFS affects 30% of women after breast cancer treatment and has significant effects on quality of life and mood. There is some evidence that CRFS is related to sleep disturbance or to a persistent inflammatory or immune response.
authors.affiliation: Division of Mental Health, St George's University of London, 6th Floor Hunter Wing, Cranmer Terrace, London SW17 ORE, United Kingdom.
authors.forename: S
authors.initials: S
authors.lastname: Alexander
authors.forename: O
authors.initials: O
authors.lastname: Minton
authors.forename: P
authors.initials: P
authors.lastname: Andrews
authors.forename: P
authors.initials: P
authors.lastname: Stone
mesh_terms: D000328:Adult; D000339:Affect; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000150:complications* / Q000523:psychology; D018572:Disease-Free Survival; D005221:Fatigue / Q000209:etiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology; D011795:Surveys and Questionnaires; D013577:Syndrome