Biering Karin, Frydenberg Morten, Pappot Helle, Hjollund Niels Henrik
Danish Ramazzini Centre, Department of Occupational Medicine, University Research Clinic, Regional Hospital West Jutland, Herning, Denmark.
Section of Biostatistics, Department of Public Health, Aarhus University, Aarhus, Denmark.
J Patient Rep Outcomes. 2020 May 18;4(1):37. doi: 10.1186/s41687-020-00187-9.
Fatigue following breast cancer is a well-known problem, with both high and persistent prevalence. Previous studies suffer from lack of repeated measurements, late recruitment and short periods of follow-up. The course of fatigue from diagnosis and treatment to the long-time outcome status is unknown as well as differences in the level of fatigue between treatment regimens. The purpose of this study was to describe the long-time course of fatigue from the time of clinical suspicion of breast cancer, its dependence of patient characteristics and treatment regimens and the comparison with the course of fatigue among women with the same suspicion, but not diagnosed with breast cancer.
Three hundred thirty-two women referred to acute or subacute mammography was followed with questionnaires from before the mammography and up to 1500 days. Fatigue was measured by the Multidimensional Fatigue Inventory (MFI-20). The women reported their initial level of fatigue before the mammography and thus without knowledge of whether they had cancer or not. Both women with and without cancer were followed. Women with cancer were identified in the clinical database established by Danish Breast Cancer Cooperative Group (DBCG) to collect information on treatment regimen.
Compared to fatigue scores before diagnosis, women with breast cancer reported a large increase of fatigue, especially in the first 6 months, followed by a slow decrease over time. Despite the long follow-up period, the women with breast cancer did not return to their level of fatigue at time of the mammography. Women without breast cancer, experienced a rapid decrease of fatigue after disproval of diagnosis followed by a steadier period.
Fatigue is a persistent problem in women diagnosed with breast cancer, even several years following diagnosis and treatment. The women with breast cancer were most affected by fatigue in the first 6 months after diagnosis.
乳腺癌后的疲劳是一个众所周知的问题,其患病率高且持续存在。以往的研究存在缺乏重复测量、招募时间晚和随访期短的问题。从诊断和治疗到长期结局状态的疲劳病程尚不清楚,不同治疗方案之间的疲劳程度差异也不明确。本研究的目的是描述从临床怀疑乳腺癌开始的疲劳长期病程、其对患者特征和治疗方案的依赖性,以及与有相同怀疑但未诊断为乳腺癌的女性的疲劳病程进行比较。
对332名转诊至急性或亚急性乳腺钼靶检查的女性进行随访,从乳腺钼靶检查前开始,随访长达1500天。采用多维疲劳量表(MFI-20)测量疲劳程度。这些女性在乳腺钼靶检查前报告了她们最初的疲劳水平,因此并不知道自己是否患有癌症。对患有和未患有癌症的女性均进行随访。通过丹麦乳腺癌合作组(DBCG)建立的临床数据库确定患有癌症的女性,以收集治疗方案信息。
与诊断前的疲劳评分相比,乳腺癌患者报告疲劳程度大幅增加,尤其是在最初6个月,随后随时间缓慢下降。尽管随访期很长,但乳腺癌患者并未恢复到乳腺钼靶检查时的疲劳水平。未患乳腺癌的女性在排除诊断后疲劳迅速下降,随后进入较为稳定的阶段。
疲劳是诊断为乳腺癌的女性持续存在的问题,即使在诊断和治疗后的数年也是如此。乳腺癌患者在诊断后的前6个月受疲劳影响最大。