Maass Saskia W M C, Brandenbarg Daan, Boerman Liselotte M, Verhaak Peter F M, de Bock Geertruida H, Berendsen Annette J
Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, PO Box 196, 9700 AD Groningen, The Netherlands.
NIVEL, Netherlands Institute of Health Services Research, 3513 CR Utrecht, The Netherlands.
Cancers (Basel). 2021 Mar 15;13(6):1301. doi: 10.3390/cancers13061301.
Fatigue is the most common and persistent symptom among women in the first five years after a breast cancer diagnosis. However, long-term prevalence of fatigue, among breast cancer survivors, needs further investigation.
To compare fatigue experienced by long-term breast cancer survivors with that in a reference population and to evaluate the determinants of that fatigue.
A cross-sectional cohort study of 350 breast cancer survivors ≥5 years after diagnosis and a reference population of 350 women matched by age and general practitioner.
Fatigue was measured using the Multidimensional Fatigue Inventory (MFI-20), and a sum score of >60 (multidimensional fatigue) was the primary outcome. Logistic regression was applied to compare the prevalence of multidimensional fatigue between the survivor and reference populations, adjusted for body mass index (BMI) and for cardiovascular and psychological variables. Odds ratios (ORs) and 95% confidence intervals (95%CIs) were estimated. Logistic regression was applied to evaluate the determinants of multidimensional fatigue among the survivors.
Breast cancer survivors (median 10 years after diagnosis), more often experienced multidimensional fatigue than the reference population (26.6% versus 15.4%; OR, 2.0 [95%CI, 1.4-2.9]), even after adjusting for confounders. The odds of multidimensional fatigue were also higher among survivors with symptoms of depression (32.2% versus 2.7%; OR, 17.0 [95%CI, 7.1-40.5]) or anxiety (41.9% versus 10.1%; OR, 6.4 [95%CI, 3.6-11.4]).
One in four breast cancer survivors experience multidimensional fatigue and fatigue occurs more frequently than in women of the same age and general practitioner. This fatigue appears to be associated with symptoms of depression and anxiety.
疲劳是乳腺癌确诊后前五年女性中最常见且持续存在的症状。然而，乳腺癌幸存者中疲劳的长期患病率仍需进一步研究。
比较长期乳腺癌幸存者与参照人群所经历的疲劳情况，并评估该疲劳的决定因素。
一项横断面队列研究，研究对象为350名确诊后≥5年的乳腺癌幸存者以及350名年龄和家庭医生相匹配的女性组成的参照人群。
使用多维疲劳量表（MFI-20）测量疲劳程度，主要结局指标为总分>60（多维疲劳）。应用逻辑回归比较幸存者和参照人群中多维疲劳的患病率，并对体重指数（BMI）、心血管和心理变量进行校正。估计比值比（OR）和95%置信区间（95%CI）。应用逻辑回归评估幸存者中多维疲劳的决定因素。
乳腺癌幸存者（确诊后中位时间为10年）比参照人群更常经历多维疲劳（26.6%对15.4%；OR为2.0[95%CI，1.4 - 2.9]），即使在对混杂因素进行校正后也是如此。有抑郁症状的幸存者中多维疲劳的几率也更高（32.2%对2.7%；OR为17.0[95%CI，7.1 - 40.5]）或有焦虑症状的幸存者（41.9%对10.1%；OR为6.4[95%CI，3.6 - 11.4]）。
四分之一的乳腺癌幸存者经历多维疲劳，且疲劳的发生比同龄且有相同家庭医生的女性更频繁。这种疲劳似乎与抑郁和焦虑症状有关。
