title: Fatigue in breast cancer patients on adjuvant treatment: course and prevalence.
abstract: BACKGROUND
  Fatigue is a major complain in breast cancer patients and survivors. Patterns and degree varies with schedule and type of the treatment. Different co-factors may aggravate fatigue. Multimodal approach is helpful in managing fatigue.
  
  
  OBJECTIVE
  To quantify prevalence, course and degree of fatigue in breast cancer patients on adjuvant treatment and effectiveness of different management approach.
  
  
  METHODS
  One Hundred and ten post-mastectomy breast cancer patients (Stage I to Stage III) were assessed. Patients on chemotherapy were assessed one week before, day after chemotherapy and two weeks later in every cycle. Patients on External Beam Radiation Therapy (EBRT) were assessed one week before and every week during radiation. Assessment was continued on second and fourth week of follow up. Functional Assessment of Chronic Illness Therapy - Fatigue subscale (FACIT-F) was used for assessment. Significant cofactors were also searched for.
  
  
  RESULTS
  Eighty four percent patients experienced fatigue. Fatigue was more prevalent during chemotherapy (91%) than EBRT (77%). Patients on Chemotherapy exhibit peak fatigue day after Chemotherapy and decreased level until the next cycle. Significant increase of fatigue was seen only in first cycle. Patient on EBRT had gradually increased fatigue during the course of treatment. Lower degree of fatigue was present in post treatment period. Anemia was a significant cofactor causing fatigue (P < 0.05). Blood Transfusion improved fatigue scores.
  
  
  CONCLUSIONS
  Fatigue increases during chemotherapy and or EBRT. Different intervention strategies are needed to address the issue.
authors.affiliation: Department of Radiotherapy, Medical College and Hospitals, Kolkata, West Bengal, India.
authors.forename: Kazi S
authors.initials: KS
authors.lastname: Manir
authors.forename: Kallol
authors.initials: K
authors.lastname: Bhadra
authors.forename: Gaurav
authors.initials: G
authors.lastname: Kumar
authors.forename: Amitabha
authors.initials: A
authors.lastname: Manna
authors.forename: Niladri B
authors.initials: NB
authors.lastname: Patra
authors.forename: Shyamal K
authors.initials: SK
authors.lastname: Sarkar
keywords: Breast cancer; Chemotherapy; External beam radiation therapy; Fatigue