Fatigue among Long-Term Breast Cancer Survivors: A Controlled Cross-Sectional Study

Background: Fatigue is the most common and persistent symptom among women in the first five years after a breast cancer diagnosis. However, long-term prevalence of fatigue, among breast cancer survivors, needs further investigation. Aim: To compare fatigue experienced by long-term breast cancer survivors with that in a reference population and to evaluate the determinants of that fatigue. Design and Setting: A cross-sectional cohort study of 350 breast cancer survivors ≥5 years after diagnosis and a reference population of 350 women matched by age and general practitioner. Method: Fatigue was measured using the Multidimensional Fatigue Inventory (MFI-20), and a sum score of >60 (multidimensional fatigue) was the primary outcome. Logistic regression was applied to compare the prevalence of multidimensional fatigue between the survivor and reference populations, adjusted for body mass index (BMI) and for cardiovascular and psychological variables. Odds ratios (ORs) and 95% confidence intervals (95%CIs) were estimated. Logistic regression was applied to evaluate the determinants of multidimensional fatigue among the survivors. Results: Breast cancer survivors (median 10 years after diagnosis), more often experienced multidimensional fatigue than the reference population (26.6% versus 15.4%; OR, 2.0 [95%CI, 1.4–2.9]), even after adjusting for confounders. The odds of multidimensional fatigue were also higher among survivors with symptoms of depression (32.2% versus 2.7%; OR, 17.0 [95%CI, 7.1–40.5]) or anxiety (41.9% versus 10.1%; OR, 6.4 [95%CI, 3.6–11.4]). Conclusion: One in four breast cancer survivors experience multidimensional fatigue and fatigue occurs more frequently than in women of the same age and general practitioner. This fatigue appears to be associated with symptoms of depression and anxiety.

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Symptoms in long-term breast cancer survivors: A cross-sectional study in primary care

The Breast ◽

10.1016/j.breast.2020.09.013 ◽

2020 ◽

Vol 54 ◽

pp. 133-138 ◽

Cited By ~ 1

Author(s):

S.W.M.C. Maass ◽

L.M. Boerman ◽

D. Brandenbarg ◽

P.F.M. Verhaak ◽

J.H. Maduro ◽

...

Keyword(s):

Breast Cancer ◽

Primary Care ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional

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Health status among long-term breast cancer survivors suffering from higher levels of fatigue: a cross-sectional study

Supportive Care in Cancer ◽

10.1007/s00520-018-4240-z ◽

2018 ◽

Vol 26 (10) ◽

pp. 3649-3658 ◽

Cited By ~ 2

Author(s):

Francisco Álvarez-Salvago ◽

Noelia Galiano-Castillo ◽

Manuel Arroyo-Morales ◽

Mayra Cruz-Fernández ◽

Mario Lozano-Lozano ◽

...

Keyword(s):

Breast Cancer ◽

Health Status ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional

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Fatigue among long-term breast cancer survivors: a controlled cross-sectional study

European Journal of Cancer ◽

10.1016/s0959-8049(20)30533-5 ◽

2020 ◽

Vol 138 ◽

pp. S1-S2

Author(s):

S. Maass ◽

D. Brandenbarg ◽

L. Boerman ◽

P. Verhaak ◽

G. de Bock ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional

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Long-term psychological distress in breast cancer survivors and their matched controls: A cross-sectional study

Maturitas ◽

10.1016/j.maturitas.2019.09.003 ◽

2019 ◽

Vol 130 ◽

pp. 6-12 ◽

Cited By ~ 5

Author(s):

S.W.M.C. Maass ◽

L.M. Boerman ◽

P.F.M. Verhaak ◽

J. Du ◽

G.H. de Bock ◽

...

Keyword(s):

Breast Cancer ◽

Psychological Distress ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional

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Associations between multimorbidity and depression among breast cancer survivors within the UK Biobank cohort: a cross-sectional study

BMC Cancer ◽

10.1186/s12885-021-08409-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Murray Foster ◽

Claire L. Niedzwiedz

Keyword(s):

Breast Cancer ◽

Mental Health ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Breast Cancer Diagnosis ◽

Cancer Registries ◽

Cross Sectional Study ◽

Uk Biobank ◽

Cross Sectional ◽

The Uk

Abstract Background Advances in the early detection of cancer and its treatment have resulted in an increasing number of people living with and beyond breast cancer. Multimorbidity is also becoming more common in this population as more people live longer with breast cancer and experience late effects of cancer treatment. Breast cancer survivors have heightened risk of depression, but to what extent multimorbidity affects the mental health of this population is less clear. This study aims to investigate the association between multimorbidity and depression among women living with and beyond breast cancer in the UK Biobank cohort. Methods Data from UK Biobank (recruitment during 2006 to 2010, aged 40–70 years) were used to identify 8438 women with a previous diagnosis of breast cancer via linked cancer registries in England, Scotland and Wales. The lifetime number of chronic conditions was self-reported and multimorbidity defined as 0, 1, 2, 3, 4 or 5+. The Patient Health Questionnaire (PHQ-2) was used to define participants that were likely to have depression based on their symptom reporting at baseline. Logistic regression models were used to analyse the associations between multimorbidity and depression, accounting for a number of potential sociodemographic confounding variables (including age, ethnicity, socioeconomic deprivation, education level and marital status) and characteristics related to the cancer (number of years since diagnosis and recurrence/secondary cancer). Results Multimorbidity was common among breast cancer survivors, with 32.9% of women experiencing one and 30.1% experiencing two or more chronic health conditions. Hypertension (25.8%), painful conditions (18.3%), and asthma (11.6%) were the three most common co-morbid conditions. 5.3% of participants had current depression. A strong, dose-response relationship was found between multimorbidity and the likelihood of depression (OR = 2.09, 95% CI: 1.56–2.79 for two conditions and OR = 6.06, 95% CI: 3.63–10.14 for five or more conditions). Conclusions Multimorbidity and depression were strongly associated among female UK Biobank participants with a previous breast cancer diagnosis. This association became increasingly pronounced as the number of chronic comorbid conditions increased. As more people survive cancer for longer, increasing recognition and support for multimorbidity and its impact on mental health is needed.

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Individual courses and determinants of fear of cancer recurrence in long-term breast cancer survivors with and without recurrence

Supportive Care in Cancer ◽

10.1007/s00520-021-06329-z ◽

2021 ◽

Author(s):

Paula Heidkamp ◽

Clara Breidenbach ◽

Kati Hiltrop ◽

Christoph Kowalski ◽

Anna Enders ◽

...

Keyword(s):

Breast Cancer ◽

Logistic Regression ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Cancer Recurrence ◽

Fear Of Cancer Recurrence ◽

Chi Square ◽

Need For Support ◽

Fear Of Cancer

Abstract Objective This study investigated the prevalence, individual courses, and determinants of fear of cancer recurrence (FoR) in long-term breast cancer survivors (BCSs) with and without recurrence. Methods A total of 184 breast cancer survivors were surveyed at four measurement time points: during hospitalization (T1), 10 weeks (T2), 40 weeks (T3), and 5–6 years (T4) after hospital discharge. Descriptive statistics, chi-square tests, and logistic regression were performed. Results Respondents were females and 57 years old, on average. At T1, T3, and T4, 54.8%, 31.6%, and 29.7% of BCSs, respectively, were classified as having dysfunctional levels of FoR. Dysfunctional FoR decreased from T1 to T3 (χ2(1) = 17.11, p = 0.000; N = 163) and remained stable afterwards. Eight subgroups of individual courses of FoR over time could be described: (1) constant functional FoR; (2) constant dysfunctional FoR; (3) improving from dysfunctional to functional FoR from T1 to T3; (4) improving from dysfunctional to functional FoR from T3 to T4; (5) worsening from functional to dysfunctional FoR from T1 to T3; (6) worsening from functional to dysfunctional FoR from T3 to T4; (7) dysfunctional FoR at T1 and T4, and functional FoR in between; and (8) functional FoR at T1 and T4, and dysfunctional FoR in between. Logistic regression analysis revealed that being divorced/widowed, showing high levels of fatigue, being treated by chemotherapy, and having low confidence in treatment were associated with dysfunctional FoR 5 to 6 years after diagnosis (Nagelkerkes’ Pseudo-R2 = 0.648). Conclusions The findings reveal that FoR is a significant issue in long-term BCSs and has the potential to become a persistent psychological strain. We emphasize the need for increased awareness of FoR among BCSs and the need for support programs.

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Depression als Begleiterkrankung – auch noch Jahre nach der Therapie

Deutsche Zeitschrift für Onkologie ◽

10.1055/a-1379-4898 ◽

2021 ◽

Vol 53 (01) ◽

pp. 22-26

Keyword(s):

Breast Cancer ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Female Population ◽

Population Controls

Doege D, Thong MS, Koch-Gallenkamp L et al.Age-specific prevalence and determinants of depression in long-term breast cancer survivors compared to female population controls. Cancer Med 2020; 9: 8713–8721. doi:10.1002/cam4.3476

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