Fatigue During and After Breast Cancer Therapy—A Prospective Study

• Published in: Journal of pain and symptom management 2017-03, Vol.53 (3), p.551-560
• Main Authors: Reinertsen, Kristin V., MD, PhD, Engebraaten, Olav, MD, PhD, Loge, Jon H, Cvancarova, Milada, MSc, PhD, Naume, Bjørn, Wist, Erik, Edvardsen, Hege, MSc, PhD, Wille, Elisabeth, MSc, Bjøro, Trine, Kiserud, Cecilie E., MD, PhD
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - drug therapy; Adenocarcinoma - epidemiology; Adenocarcinoma - physiopathology; Adenocarcinoma - psychology; Adult; Aged; Anesthesia & Perioperative Care; Antineoplastic Agents - adverse effects; Antineoplastic Agents - therapeutic use; bevacizumab; Bevacizumab - adverse effects; Bevacizumab - therapeutic use; Biomarkers - blood; Breast cancer; Breast Neoplasms - drug therapy; Breast Neoplasms - epidemiology; Breast Neoplasms - physiopathology; Breast Neoplasms - psychology; C-reactive protein; C-reactive protein (CRP); C-Reactive Protein - metabolism; Chemotherapy; chronic fatigue; Chronic fatigue syndrome; Chronic pain; Clinical variables; Fatigue; Fatigue - epidemiology; Fatigue - etiology; Fatigue - physiopathology; Fatigue - psychology; Female; Follow-Up Studies; Humans; Immune response; Inflammation; Inflammation - epidemiology; Inflammation - physiopathology; Inflammation - psychology; Longitudinal Studies; Middle Aged; Monoclonal antibodies; Multivariate analysis; Pain - epidemiology; Pain - physiopathology; Pain - psychology; Pain Medicine; Prevalence; Prospective Studies; Psychological distress; Questionnaires; Stress, Psychological - epidemiology; Stress, Psychological - physiopathology; Stress, Psychological - psychology; Surgery; Survivor; Targeted cancer therapy; Treatment Outcome; Women
• ISSN: 0885-3924; 1873-6513
• DOI: 10.1016/j.jpainsymman.2016.09.011

Abstract Context Chronic fatigue (CF) in breast cancer (BC) survivors is multifactorial and may be caused by immune activation triggered by BC or its treatment. In the Neoadjuvant Avastin in Breast Cancer study, BC patients received neoadjuvant chemotherapy (FEC100→taxane) ± bevacizumab, a monoclonal antibody with fatigue as a potential side effect. Objectives To examine fatigue levels and prevalence of CF before and during chemotherapy and at follow-up, and their associations with C-reactive protein (CRP) and clinical variables. Methods Eighty-four HER2-negative patients with cT2-4N0-3M0 BC responded to questionnaires and had CRP measured before treatment (T0), after FEC100 (T1), after taxanes before surgery (T2), and at two-year follow-up (T3). Results The prevalence of CF increased from 8% at T0 to 36% at T3, P