Long-Term Longitudinal Patterns of Patient-Reported Fatigue After Breast Cancer: A Group-Based Trajectory Analysis
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PURPOSE: Fatigue is recognized as one of the most burdensome and long-lasting adverse effects of cancer and cancer treatment. We aimed to characterize long-term fatigue trajectories among breast cancer survivors. METHODS: We performed a detailed longitudinal analysis of fatigue using a large ongoing national prospective clinical study (CANcer TOxicity, ClinicalTrials.gov identifier: NCT01993498 ) of patients with stage I-III breast cancer treated from 2012 to 2015. Fatigue was assessed at diagnosis and year 1, 2, and 4 postdiagnosis. Baseline clinical, sociodemographic, behavioral, tumor-related, and treatment-related characteristics were available. Trajectories of fatigue and risk factors of trajectory-group membership were identified by iterative estimates of group-based trajectory models. RESULTS: Three trajectory groups were identified for severe global fatigue (n = 4,173). Twenty-one percent of patients were in the high-risk group, having risk estimates of severe global fatigue of 94.8% (95% CI, 86.6 to 100.0) at diagnosis and 64.6% (95% CI, 59.2 to 70.1) at year 4; 19% of patients clustered in the deteriorating group with risk estimates of severe global fatigue of 13.8% (95% CI, 6.7 to 20.9) at diagnosis and 64.5% (95% CI, 57.3 to 71.8) at year 4; 60% were in the low-risk group with risk estimates of 3.6% (95% CI, 2.5 to 4.7) at diagnosis and 9.6% (95% CI, 7.5 to 11.7) at year 4. The distinct dimensions of fatigue clustered in different trajectory groups than those identified by severe global fatigue, being differentially affected by sociodemographic, clinical, and treatment-related factors. CONCLUSION: Our findings highlight the multidimensional nature of cancer-related fatigue and the complexity of its risk factors. This study helps to identify patients with increased risk of severe fatigue and to inform personalized interventions to ameliorate this problem.
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Previous data have demonstrated considerable interindividuality in the onset, persistence, and longitudinal evolution of treatment-related symptoms.
“Previous data have demonstrated considerable interindividuality in the onset, persistence, and longitudinal evolution of treatment-related symptoms,5,61,62”
From Implementing a PROACTive Care Pathway to Empower and Support Survivors of Breast Cancer (2023) · cites this paper as [62]
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- Authors
- Vaz-Luis, I., Di Meglio, A., Havas, J., El-Mouhebb, M., Lapidari, P., Presti, D., Soldato, D., Pistilli, B., Dumas, A., Menvielle, G., Charles, C., Everhard, S., Martin, A.-L., Cottu, P. H., Lerebours, F., Coutant, C., Dauchy, S., Delaloge, S., Lin, N. U., Ganz, P. A., Partridge, A. H., André, F., & Michiels, S.
- Affiliations
- Gustave Roussy, Medical Oncology, Villejuif, France
- Inserm (FR)
- INSERM Unit 981–Molecular Predictors and New Targets in Oncology, Gustave Roussy, University Paris-Saclay, Villejuif, France
- Universite de Paris, ECEVE UMR 1123, INSERM, Paris, France
- Gustave Roussy, Supportive Care, IPLESP, Paris, France
- UniCancer Group (FR)
- Institut Curie (FR)
- Centre Georges François Leclerc (FR)
- Institut Gustave Roussy (FR)
- Dana-Farber Cancer Institute, Boston, MA
- University of California, Los Angeles (US)
- Dana-Farber Cancer Institute (US)
- ORCID
- Vaz-Luis, Ines
- Di Meglio, Antonio
- Havas, Julie
- Lapidari, Pietro
- Presti, Daniele
- Soldato, Davide
- Pistilli, Barbara
- Dumas, Agnes
- Menvielle, Gwenn
- Charles, Cecile
- Everhard, Sibille
- Martin, Anne-Laure
- Cottu, Paul H.
- Lerebours, Florence
- Coutant, Charles
- Dauchy, Sarah
- Delaloge, Suzette
- Lin, Nancy U.
- Ganz, Patricia A.
- Partridge, Ann H.
- André, Fabrice
- Michiels, Stefan
- Venue
- Journal of Clinical Oncology
- Published
- 2022-07-01
- Volume
- 40
- Issue
- 19
- Pages
- 2148-2162
- ISSN
- 0732-183X (ISSN-L)
- 1527-7755
- PMC
- PMC9242405
- OpenAlex
- W4220672765
- Cited by
- 65
- References
- 45
- Citations by year
- 2026: 16 · 2025: 17 · 2024: 14 · 2023: 13 · 2022: 5
- FWCI
- 2.91
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- Journal of Clinical Oncology (publishedVersion, cc-by-nc-nd)
- SSRN Electronic Journal (publishedVersion)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- HAL (submittedVersion, other-oa)
- eScholarship (California Digital Library) (submittedVersion, cc-by-nc-nd)
- Funders
- Conquer Cancer Foundation
- American Society of Clinical Oncology
- Agence Nationale de la Recherche (ANR-10-COHO-0004, ANR-18-IBHU-0002, ANR18, ANR-10)
- Institut Gustave-Roussy
- Rising Tide Foundation for Clinical Cancer Research
- Rising Tide Foundation
- 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, fatigue trajectories, patient-reported outcomes, risk factors for fatigue, multidimensional fatigue, treatment toxicity, sociodemographic factors, personalized interventions
- MeSH terms
- Patient Reported Outcome Measures, Breast Neoplasms, Fatigue, Female, Humans, Longitudinal Studies, Prospective Studies, Quality of Life, Survivors
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