Multicenter prospective cohort study of long-term fatigue after treatment for breast cancer

Patients with breast cancer (BC) may have long-term fatigue after treatment, which is associated with reduced quality of life. A multicenter retrospective cohort study in the US investigated cardiac, psychological, and cancer treatment factors associated with fatigue before and 24 months after BC treatment. The study included 236 BC patients and 145 comparators. The mean age was 54 years (SD 12). Fatigue was assessed by the FACT Fatigue scale. Two years after receiving potentially cardiotoxic chemotherapy, 34.6% of women experienced increased fatigue relative to their pretreatment fatigue level. Independent of cardiovascular risk factors, including pretreatment and posttreatment left ventricular ejection fraction (LVEF), only depressive symptoms and perceived stress were associated with and mediated the 24-month post BC treatment fatigue measures. The authors conclude that these findings suggest that clinically relevant fatigue 2 year after BC treatment is mediated partly by depressive symptoms and perceived stress irrespective of LVEF.