Prevalence, predictors, and characteristics of off-treatment fatigue in breast cancer survivors.
BACKGROUND
Lack of consensus regarding how to identify cancer patients with significant fatigue has hampered research regarding cancer-related fatigue (CRF).


METHODS
Specific criteria were used to identify CRF cases in women with stage 0-II breast cancer (BC group, n = 304). Women completed assessments before adjuvant therapy (baseline), end of adjuvant therapy (Post-Tx), and 6 and 42 months after end of adjuvant therapy (6 and 42 Month Post-Tx). At each, women completed a clinical interview and questionnaires assessing physical and mental health. A healthy control (HC) group with no history of BC (n = 337) completed 2 similar assessments 36 months apart.


RESULTS
Off-treatment CRF prevalence was 9% and 13% at the 6 and 42 Month Post-Tx assessments, respectively. Thus, 15% of the sample evidenced off-treatment CRF with 7% evidencing delayed onset CRF. CRF at the 6 Month Post-Tx assessment was associated only with CRF at baseline (OR = 3.2) and Post-Tx assessments (OR = 3.9). CRF at the 42 Month Post-Tx assessment was associated with CRF at the Post-Tx assessment (OR = 6.1), obesity at baseline, and several baseline measures of coping in response to fatigue. Off-treatment CRF cases differed markedly from CRF noncases and healthy controls on a spectrum of health status indices (mean effect size >1.0 SD).


CONCLUSIONS
Results document the prevalence of off-treatment and delayed onset CRF, suggest the utility of a cognitive-behavioral model of CRF, and support NCCN guidelines recommending monitoring fatigue across the cancer trajectory.
Andrykowski
Michael A
MA
Department of Behavioral Science, University of Kentucky, Lexington, Kentucky, USA. mandry@uky.edu
Donovan
Kristine A
KA
Laronga
Christine
C
Jacobsen
Paul B
PB
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000150:complications* / Q000628:therapy; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D005221:Fatigue / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008609:Mental Status Schedule; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D017741:Survivors