title: Fatigue after treatment in breast cancer survivors: prevalence, determinants and impact on health-related quality of life.
abstract: OBJECTIVE
  Fatigue is a phenomenon that may persist for years after completion of adjuvant therapy, and is one of the most frequent symptoms associated with breast cancer survivors. The purposes of this study were to investigate the occurrence of fatigue in disease-free breast cancer survivors after treatment, to identify variables associated with fatigue, and to evaluate the impact of fatigue on health-related quality of life.
  
  
  METHODS
  A cross-sectional study was conducted on 202 consecutive women diagnosed with in-situ to Stage III breast cancer attending in outpatient facilities of two large hospitals, one year or more after diagnosis. They completed the Piper Fatigue Scale-Revised and the European Organization for Research and Treatment of Cancer QLQ-C30. Multiple logistic regression models were used to identify predictive factors associated with fatigue. EORTC QLQC-30 scores for fatigued survivors were compared to non-fatigued survivors.
  
  
  RESULTS
  The prevalence of fatigue reported by the breast cancer survivors was 37.6%. Multiple logistic regression analysis revealed that predictive factors for fatigue included younger age (odds ratio [OR]=2.23, 95% confidence interval [CI]=1.11-4.45, p = 0.024); presence of pain (OR = 3.87, 95% CI = 1.88-7.98, p = 0.000); dyspnea (OR = 3.72, 95% CI = 1.46-9.50, p = 0.006); insomnia (OR = 2.40, 95% CI = 1.19-4.86, p = 0.015); and nausea and vomiting (OR = 12.25, 95% CI = 1.18-126.75, p = 0.036). Fatigued women had poorer health-related quality of life than non-fatigued women in all domains.
  
  
  CONCLUSIONS
  Our results suggest that many disease-free breast cancer survivors after treatment experienced fatigue that compromises their health-related quality of life.
authors: Universidade Federal do Paraná, Brazil, Curitiba, Parana, Brazil. anafabio2009@gmail.com
authors: Ana Claudia
authors: AC
authors: Garabeli Cavalli Kluthcovsky
authors: Almir Antonio
authors: AA
authors: Urbanetz
authors: Denise Siqueira
authors: DS
authors: de Carvalho
authors: Eliane Mara Cesario
authors: EM
authors: Pereira Maluf
authors: Geovana Cristina
authors: GC
authors: Schlickmann Sylvestre
authors: Sergio Bruno
authors: SB
authors: Bonatto Hatschbach
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil; D001943:Breast Neoplasms / Q000150:complications* / Q000473:pathology / Q000628:therapy*; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D018572:Disease-Free Survival; D005221:Fatigue / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011788:Quality of Life; D011795:Surveys and Questionnaires