title: Predictors and course of chronic fatigue in long-term breast cancer survivors.
abstract: BACKGROUND
  The course of fatigue in long-term breast cancer survivors (BCSs) is unknown. The current study examined chronic fatigue (CF) cross-sectionally and longitudinally in relapse-free women up to 10 years after multimodal treatment for BC stage II/III. The prevalence of persistent fatigue (PF: having CF at two assessments separated by >2 years) and its predictors were also investigated.
  
  
  METHODS
  Data from questionnaires (including the Fatigue Questionnaire and questions regarding socio-demographics and physical symptoms) were collected twice from 249 BCSs: 2.5-7 years post-BC diagnosis (T1) and 2.5-3 years thereafter (T2). A physical examination including blood sampling was performed at T1.
  
  
  RESULTS
  CF was diagnosed in 33% of the women at T1 and in 39% at T2, including 57 (23%) subjects with PF. Current psychological distress, treatment-area related discomfort and high body mass index (BMI) were associated with CF at T1 and predicted PF. Increased leukocyte count also predicted PF. Treatment for mental problems prior to the BC, increased hsCRP-level and respiratory symptoms were associated with CF at T1 but did not predict PF.
  
  
  CONCLUSIONS
  Women may experience fatigue up to 10 years after multimodal BC treatment, with about one third having CF and about one fourth having PF.
  
  
  CONCLUSIONS
  During follow-up, BCSs and their doctors should maximize their efforts to reduce psychological distress, overweight and pain within the BC-treated area, all linked to the development of persistent fatigue.
authors.affiliation: National Resource Center for Late Effects, Department of Oncology, Oslo University Hospital, Radiumhospitalet, Montebello, 0310, Oslo, Norway.
authors.forename: Kristin Valborg
authors.initials: KV
authors.lastname: Reinertsen
authors.forename: Milada
authors.initials: M
authors.lastname: Cvancarova
authors.forename: Jon H
authors.initials: JH
authors.lastname: Loge
authors.forename: Hege
authors.initials: H
authors.lastname: Edvardsen
authors.forename: Erik
authors.initials: E
authors.lastname: Wist
authors.forename: Sophie D
authors.initials: SD
authors.lastname: Fosså
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001943:Breast Neoplasms / Q000150:complications* / Q000453:epidemiology / Q000534:rehabilitation* / Q000628:therapy; D003131:Combined Modality Therapy / Q000009:adverse effects / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D018450:Disease Progression; D015673:Fatigue Syndrome, Chronic / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D011379:Prognosis; D012107:Research Design; D012307:Risk Factors; D011795:Surveys and Questionnaires; D017741:Survivors / Q000706:statistics & numerical data