Fatigue in breast cancer survivors: occurrence, correlates, and impact on quality of life.

Bower, Julienne E.; Ganz, Patricia A.; Desmond, Katherine A.; Rowland, Julia H.; Meyerowitz, Beth E.; Belin, Thomas R.

doi:10.1200/jco.2000.18.4.743

Cited by 1,134Cancer survivorship and careCancer-related cognitive impairment studiesChildhood Cancer Survivors' Quality of Life

Fatigue in breast cancer survivors: occurrence, correlates, and impact on quality of life.

Bower, Julienne E., Ganz, Patricia A., Desmond, Katherine A., Rowland, Julia H., Meyerowitz, Beth E., Belin, Thomas R.·2000·Journal of Clinical Oncology

DOI 10.1200/jco.2000.18.4.743

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Abstract

PURPOSE: To describe the occurrence of fatigue in a large sample of breast cancer survivors relative to general population norms and to identify demographic, medical, and psychosocial characteristics of fatigued survivors. PATIENTS AND METHODS: Breast cancer survivors in two large metropolitan areas completed standardized questionnaires as part of a survey study, including the RAND 36-item Health Survey, Center for Epidemiological Studies-Depression Scale, Breast Cancer Prevention Trial Symptom Checklist, Medical Outcomes Study Sleep Scale, and demographic and treatment-related measures. RESULTS: On average, the level of fatigue reported by the breast cancer survivors surveyed (N = 1,957) was comparable to that of age-matched women in the general population, although the breast cancer survivors were somewhat more fatigued than a more demographically similar reference group. Approximately one third of the breast cancer survivors assessed reported more severe fatigue, which was associated with significantly higher levels of depression, pain, and sleep disturbance. In addition, fatigued women were more bothered by menopausal symptoms and were somewhat more likely to have received chemotherapy (with or without radiation therapy) than nonfatigued women. In multivariate analyses, depression and pain emerged as the strongest predictors of fatigue. CONCLUSION: Although the majority of breast cancer survivors in this large and diverse sample did not experience heightened levels of fatigue relative to women in the general population, there was a subgroup of survivors who did report more severe and persistent fatigue. We identified characteristics of these women that may be helpful in elucidating the mechanisms underlying fatigue in this population, as well as directing intervention efforts.

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In another study of breast cancer survivors, a third of the women struggled with chronic fatigue up to 10 years into survivorship.
“In another study of breast cancer survivors, a third of the women struggled with chronic fatigue up to 10 years into survivorship [13].”
From Pre- and post-operative psychological interventions to prevent pain and fatigue after breast cancer surgery (PREVENT): Protocol for a randomized controlled trial (2022) · cites this paper as [13]
Chronic post-surgical pain and fatigue are the most common sequelae.
“Chronic post-surgical pain and fatigue are the most common sequelas [6,13].”
From Pre- and post-operative psychological interventions to prevent pain and fatigue after breast cancer surgery (PREVENT): Protocol for a randomized controlled trial (2022) · cites this paper as [13]
On average, fatigue tends to increase during cancer treatment and remit within 1 year following treatment.
“On average, fatigue tends to increase during cancer treatment and remit within 1 year following treatment [1, 33].”
From Comparative responsiveness and minimally important difference of fatigue symptom inventory (FSI) scales and the FSI-3 in trials with cancer survivors (2022) · cites this paper as [33]
In prior research, survivors with scores less than 50 on the SF-36 Vitality measure showed biological and psychological/behavioral indicators of elevated fatigue compared to survivors with scores ≥50, supporting this cut-point's validity.
“In prior research, survivors with scores less than 50 on the SF-36 Vitality measure showed biological and psychological/behavioral indicators of elevated fatigue compared to survivors with scores ≥ 50, supporting this cut-point’s validity [4, 33, 59–62].”
From Comparative responsiveness and minimally important difference of fatigue symptom inventory (FSI) scales and the FSI-3 in trials with cancer survivors (2022) · cites this paper as [33]

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Authors: Bower, J. E., Ganz, P. A., Desmond, K. A., Rowland, J. H., Meyerowitz, B. E., & Belin, T. R.
Affiliations: University of Southern California (US)
ORCID: Bower, Julienne E.
Ganz, Patricia A.
Rowland, Julia H.
Meyerowitz, Beth E.
Belin, Thomas R.
Venue: Journal of Clinical Oncology
Publisher: American Society of Clinical Oncology (ASCO)
Published: 2000-02-14
Volume: 18
Issue: 4
Pages: 743-743
ISSN: 0732-183X (ISSN-L)
1527-7755
DOI: 10.1200/jco.2000.18.4.743
OpenAlex: W2119968490
Cited by: 1,134
References: 32
Citations by year: 2026: 18 · 2025: 25 · 2024: 29 · 2023: 49 · 2022: 65 · 2021: 56 · 2020: 51 · 2019: 45 · 2018: 43 · 2017: 51 · 2016: 40 · 2015: 47 · 2014: 53 · 2013: 53 · 2012: 51
FWCI: 10.16
Type: journal article
Language: en
Open access: closed
Locations: Journal of Clinical Oncology (publishedVersion)
PubMed (publishedVersion)
Funders: National Cancer Institute (R01CA063028, R01- CA63028)
Topics: Health Sciences › Medicine › Oncology › Cancer survivorship and care
Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
Keywords: cancer-related fatigue, breast cancer survivors, quality of life, depression, pain, sleep disorders, menopausal symptoms, chemotherapy, predictors of fatigue, psychosocial factors
MeSH terms: Antineoplastic Agents, Breast Neoplasms, Depression, District of Columbia, Fatigue, Female, Forecasting, Health Status, Humans, Menopause, Middle Aged, Pain, Quality of Life, Surveys and Questionnaires, Sleep Wake Disorders, Los Angeles, Multivariate Analysis, Chi-Square Distribution, Likelihood Functions, Logistic Models, Case-Control Studies, Outcome Assessment, Health Care, Survivors, Radiotherapy, Adjuvant

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Fatigue in breast cancer survivors: occurrence, correlates, and impact on quality of life.

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