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Chronic disease
SP1-29 Fatigue and quality of life in breast cancer survivors: temporal courses and long-term pattern
  1. M Schmidt1,
  2. J Chang-Claude1,
  3. D Flesch-Janys2,
  4. K Steindorf1
  1. 1German Cancer Research Center, Heidelberg, Germany
  2. 2University Medical Center Hamburg-Eppendorf, Hamburg, Germany


Introduction Fatigue is a major severe complaint in the growing population of breast cancer survivors. Therefore, we investigated the different courses of fatigue from pre-diagnosis to long-term follow-up, and their associations with long-term quality of life (QoL) in disease-free breast cancer survivors, including comparisons with the general population.

Methods Incident breast cancer patients diagnosed 2001–2005 were recruited in a case-control study conducted in Germany (MARIE). At follow-up in 2009 (median 5.8 years), patients who were still alive self-reported current fatigue and QoL status using validated questionnaires (FAQ, EORTC-QLQ-C30). In addition, survivors retrospectively rated fatigue levels pre-diagnosis, during different treatment phases, and 1 year post-surgery. Our analyses included 1928 disease-free breast cancer survivors without elevated pre-diagnosis fatigue levels.

Results Fatigue levels were increased during radiotherapy, without significant difference between patients with and without chemotherapy. Among patients who received both therapies, 61.4% reported higher, 30% same, 8.6% lower fatigue levels during chemotherapy compared to radiotherapy. Inter-individual variation in courses of fatigue was high. Survivors with persisting long-term fatigue had significantly and markedly worse scores for all EORTC QoL functions and symptoms several years after end of adjuvant treatment than other survivors and compared to the general population.

Conclusion Chemotherapy appears to have a stronger negative impact on fatigue than radiotherapy. Breast cancer survivors may have long-term QoL comparable to the general population, even when they had substantial fatigue during treatment. However, prolonged or persistent fatigue can lead to extensive continuing loss in QoL with respect to physical, social, cognitive, and financial aspects.

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