Severe fatigue after treatment of ductal carcinoma in situ: A comparison with age-matched breast cancer survivors and healthy controls.
OBJECTIVE
Severe fatigue after treatment of ductal carcinoma in situ (DCIS) has not been studied before. The current study examined (i) the prevalence of severe fatigue in DCIS patients versus breast cancer survivors (BCS) and healthy controls (HC), (ii) quality of life and functioning of severely versus non-severely fatigued DCIS patients and BCS, and (iii) the association of fatigue with psychosocial and behavioral factors in DCIS patients.


METHODS
89 patients treated for DCIS were matched on age and gender to 67 BCS and 178 HC (ratio 1:1:2). Fatigue was measured with the Fatigue Severity subscale of the Checklist Individual Strength.


RESULTS
23% of DCIS patients, 25% of BCS, and 6% of HC were severely fatigued (DCIS versus HC: p < 0.001). Severely fatigued DCIS patients had a lower quality of life and were more impaired in all domains of functioning than non-severely fatigued DCIS patients. Sleep problems, dysfunctional cognitions regarding fatigue, avoidance of activities, all-or-nothing behavior, perceived lack of social support, DCIS-related coping problems, and fear of future cancer occurrence were related to fatigue.


CONCLUSIONS
The prevalence of severe fatigue in DCIS patients was similar to BCS, but higher than in HC. Severely fatigued DCIS patients had a lower quality of life and more functional impairments. The psychosocial and behavioral fatigue-related factors in DCIS patients are known to perpetuate fatigue in BCS. These factors can be targeted in interventions for cancer-related fatigue. Our findings suggest that the same treatment elements might be applicable to severely fatigued DCIS patients.
Expert Center for Chronic Fatigue, Radboud University Medical Center, PO Box 9101, 916, 6500 HB, Nijmegen, The Netherlands. Electronic address: harriet.abrahams@radboudumc.nl.
H J G
HJG
Abrahams
Expert Center for Chronic Fatigue, Radboud University Medical Center, PO Box 9101, 916, 6500 HB, Nijmegen, The Netherlands. Electronic address: lies_smits333@hotmail.com.
L
L
Smits
Department of Medical Psychology, Hospital Gelderse Vallei, PO Box 9025, 6710 HN, Ede, The Netherlands. Electronic address: LugtM@zgv.nl.
M de
M
Lugt
Department of Surgery, Hospital Gelderse Vallei, PO Box 9025, 6710 HN, Ede, The Netherlands. Electronic address: DeRoosW@zgv.nl.
W K de
WK
Roos
Department of Medical Oncology, Hospital Pantein, Dokter Kopstraat 1, 5835 DV, Beugen, The Netherlands. Electronic address: y.kamm@Pantein.nl.
Y
Y
Kamm
Netherlands Institute for Health Services Research (NIVEL), PO Box 1568, 3500 BN, Utrecht, The Netherlands. Electronic address: M.Heins@nivel.nl.
M J
MJ
Heins
Department of Medical Oncology, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands. Electronic address: Stans.Verhagen@radboudumc.nl.
C A H H V M
CAHHVM
Verhagen
Department of Medical Psychology, Academic Medical Center (AMC), University of Amsterdam, PO Box 22660, 1100 DD, Amsterdam, The Netherlands. Electronic address: marieke.gielissen@radboudumc.nl.
M F M
MFM
Gielissen
Expert Center for Chronic Fatigue, Radboud University Medical Center, PO Box 9101, 916, 6500 HB, Nijmegen, The Netherlands; Department of Medical Psychology, Academic Medical Center (AMC), University of Amsterdam, PO Box 22660, 1100 DD, Amsterdam, The Netherlands. Electronic address: hans.knoop@amc.uva.nl.
H
H
Knoop
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000523:psychology / Q000628:therapy*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000523:psychology / Q000628:therapy*; D016022:Case-Control Studies; D060825:Cognitive Dysfunction / Q000523:psychology; D003430:Cross-Sectional Studies; D005221:Fatigue / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D011788:Quality of Life; D012893:Sleep Wake Disorders / Q000523:psychology; D012944:Social Support; D017741:Survivors / Q000523:psychology*
Breast cancer; DCIS; Ductal carcinoma in situ; Fatigue; Quality of life