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Prevalence, predictors, and characteristics of off-treatment fatigue in breast cancer survivors
Version of Record online: 23 AUG 2010
Copyright © 2010 American Cancer Society
Volume 116, Issue 24, pages 5740–5748, 15 December 2010
How to Cite
Andrykowski, M. A., Donovan, K. A., Laronga, C. and Jacobsen, P. B. (2010), Prevalence, predictors, and characteristics of off-treatment fatigue in breast cancer survivors. Cancer, 116: 5740–5748. doi: 10.1002/cncr.25294
- Issue online: 3 DEC 2010
- Version of Record online: 23 AUG 2010
- Manuscript Accepted: 4 FEB 2010
- Manuscript Revised: 2 FEB 2010
- Manuscript Received: 25 NOV 2009
- late effects
Lack of consensus regarding how to identify cancer patients with significant fatigue has hampered research regarding cancer-related fatigue (CRF).
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.
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).
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. Cancer 2010. © 2010 American Cancer Society.