Factors of the evolution of fatigue dimensions in patients with breast cancer during the 2 years after surgery
Menée en France à partir des données portant sur 459 patientes atteintes d'un cancer du sein, cette étude de cohorte identifie les facteurs associés à l'évolution de leur fatigue pendant les 2 années suivant un traitement chirurgical
Women with breast cancer are increasingly being cured of the disease but fatigue remains the most frequently reported symptom. The aims of this study were to identify distinct trajectories in 4 fatigue dimensions during 2 years after breast cancer surgery and to explore the demographic, clinical and personality characteristics associated with these profiles. We included women from the prospective longitudinal multicenter FATSEIN cohort in France. They completed the Multidimensional Fatigue Inventory for 9 follow‐ups over 24 months after surgery. A group‐based trajectory model identified distinct trajectories in each fatigue dimension. Multinomial logistic regression determined the factors associated with each profile. From the 459 women followed, 3 to 5 fatigue trajectories were revealed in each fatigue dimension, from its absence to its severest degree. In our multivariate analysis, the risk of severe fatigue was decreased in all dimensions by a high quality of life before surgery (measured by the European Organization for Research and Treatment of Cancer 30‐item QoL questionnaire) (e.g. for general and physical fatigue: OR = 0.93, 95% CI 0.91, 0.96), especially a high physical and emotional functions for general and physical fatigue, and a high cognitive function for mental fatigue. Both severe mental fatigue and severe reduced motivation worsened with low optimism before surgery (e.g. for mental fatigue: OR = 0.93, 95% CI 0.89, 0.97). Severe reduced activities increased by having chemotherapy (OR = 9.41, 95% CI 2.28, 38.79). Targeting women at risk for severe fatigue can provide early preventive and curative treatment and appropriate psychological support.