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Long-Term Longitudinal Patterns of Patient-Reported Fatigue After Breast Cancer: A Group-Based Trajectory Analysis

22 Pages Posted: 18 Jun 2021

See all articles by Ines Vaz-Luis

Ines Vaz-Luis

University of Paris-Saclay - Medical Oncology; University of Paris-Saclay - INSERM Unit 981

Antonio Di Meglio

University of Paris-Saclay - INSERM Unit 981

Julie Havas

University of Paris-Saclay - INSERM Unit 981

Mayssam El-Mouhebb

University of Paris-Saclay - INSERM Unit 981

Pietro Lapidari

University of Paris-Saclay - INSERM Unit 981

Daniele Presti

University of Paris-Saclay - INSERM Unit 981

Davide Soldato

University of Paris-Saclay - INSERM Unit 981

Barbara Pistilli

University of Paris-Saclay - Medical Oncology

Agnes Dumas

University of Paris

Gwenn Menvielle

Sorbonne University

Cecile Charles

University of Paris-Saclay

Sibille Everhard

UNICANCER

Anne-Laure Martin

UNICANCER

Paul Henri Cottu

École Normale Supérieure - PSL Research University - Institut Curie

Florence Lerebours

École Normale Supérieure - PSL Research University - Institut Curie

Charles Coutant

Centre Georges-Francois Leclerc

Sarah Dauchy

University of Paris-Saclay

Suzette Delaloge

Gustave Roussy Villejuif

Nancy Lin

Harvard University - Dana-Farber Cancer Institute

Patricia Anne Ganz

University of California, Los Angeles (UCLA)

Ann H. Partridge

Harvard University - Dana-Farber Cancer Institute

Fabrice André

Gustave Roussy Cancer Campus

Stefan Michiels

University of Paris-Saclay

More...

Abstract

Background: Fatigue is a multidimensional symptom. It is recognised as one of the most burdensome and long-lasting adverse effects of cancer and cancer treatment. We aimed to characterise long-term fatigue trajectories among breast cancer survivors.

Methods: We performed a detailed longitudinal analysis of fatigue using a large ongoing national prospective clinical study (CANcer TOxicity, NCT01993498) of patients with stage I–III breast cancer treated from 2012–2015. Fatigue was assessed at diagnosis (baseline), year-one, -two, and -four post-diagnosis. Baseline clinical, socio-demographic, behavioural, tumour- and treatment-related characteristics were available. Trajectories of fatigue and risk factors of trajectory-group membership were identified by iterative estimates of group-based trajectory models and multivariable logistic regression.

Findings: Three trajectory-groups were identified for severe global fatigue (N=4173). Twenty-one per cent of patients were in the "High" risk group, having a risk estimate of severe global fatigue of 94·8% [95% confidence interval (CI) 86·6–100·0] at diagnosis and 64·8% [95% CI 59·2–70·1] at year four; 19% of patients clustered in the "Deteriorating" group with a risk estimate of severe global fatigue of 13·8% [95% CI 6·7%–20·9%] at diagnosis and  64·5% [95% CI 57·3–71·8] at year four; and 60% were in the “Low” risk group with a risk estimate of 3·6% [95% CI 2·5–4·7] at diagnosis and 9·6% [95% CI 7·5–11·7] at year four). The distinct dimensions of fatigue clustered in different trajectory groups than those identified by severe global fatigue, being differentially impacted by socio-demographic, clinical, and treatment-related factors.

Interpretation: Our findings highlight the multidimensional nature of cancer-related fatigue and the complexity of its risk factors. This study helps to identify patients with increased risk of severe fatigue and to inform personalised interventions to ameliorate this problem.

Funding: Susan G. Komen, French Foundation for Cancer Research, Foundation Gustave Roussy, and French Government (Agence Nationale de la recherché [ANR]).

Declaration of Interest: None to declare.

Ethical Approval: All study participants provided informed consent, and the national regulatory and ethics committee approved the study (ID-RCB:2011-A01095-36,11-039).

Suggested Citation

Vaz-Luis, Ines and Di Meglio, Antonio and Havas, Julie and El-Mouhebb, Mayssam and Lapidari, Pietro and Presti, Daniele and Soldato, Davide and Pistilli, Barbara and Dumas, Agnes and Menvielle, Gwenn and Charles, Cecile and Everhard, Sibille and Martin, Anne-Laure and Cottu, Paul Henri and Lerebours, Florence and Coutant, Charles and Dauchy, Sarah and Delaloge, Suzette and Lin, Nancy and Ganz, Patricia Anne and Partridge, Ann H. and André, Fabrice and Michiels, Stefan, Long-Term Longitudinal Patterns of Patient-Reported Fatigue After Breast Cancer: A Group-Based Trajectory Analysis. Available at SSRN: https://ssrn.com/abstract=3869654 or http://dx.doi.org/10.2139/ssrn.3869654

Ines Vaz-Luis (Contact Author)

University of Paris-Saclay - Medical Oncology ( email )

Villejuif
France
+33 (0)142114827 (Phone)

University of Paris-Saclay - INSERM Unit 981

Villejuif
France

Antonio Di Meglio

University of Paris-Saclay - INSERM Unit 981 ( email )

Villejuif
France

Julie Havas

University of Paris-Saclay - INSERM Unit 981 ( email )

Villejuif
France

Mayssam El-Mouhebb

University of Paris-Saclay - INSERM Unit 981 ( email )

Villejuif
France

Pietro Lapidari

University of Paris-Saclay - INSERM Unit 981 ( email )

Villejuif
France

Daniele Presti

University of Paris-Saclay - INSERM Unit 981 ( email )

Villejuif
France

Davide Soldato

University of Paris-Saclay - INSERM Unit 981 ( email )

Villejuif
France

Barbara Pistilli

University of Paris-Saclay - Medical Oncology ( email )

Villejuif
France

Agnes Dumas

University of Paris ( email )

Paris
France

Gwenn Menvielle

Sorbonne University ( email )

UFR 927, 4 Place Jussieu
Paris, F-75252
France

Cecile Charles

University of Paris-Saclay ( email )

55 Avenue de Paris
Versailles, 78000
France

Sibille Everhard

UNICANCER ( email )

Paris
France

Anne-Laure Martin

UNICANCER ( email )

Paris
France

Paul Henri Cottu

École Normale Supérieure - PSL Research University - Institut Curie ( email )

26 rue d'Ulm
Paris cedex 05
Paris, 75248
France

Florence Lerebours

École Normale Supérieure - PSL Research University - Institut Curie ( email )

26 rue d'Ulm
Paris cedex 05
Paris, 75248
France

Charles Coutant

Centre Georges-Francois Leclerc ( email )

Dijon
France

Sarah Dauchy

University of Paris-Saclay ( email )

55 Avenue de Paris
Versailles, 78000
France

Suzette Delaloge

Gustave Roussy Villejuif ( email )

114 Rue Edouard Vaillant
94800 Villejuif
France

Nancy Lin

Harvard University - Dana-Farber Cancer Institute ( email )

450 Brookline Avenue
Boston, MA 02215
United States

Patricia Anne Ganz

University of California, Los Angeles (UCLA) ( email )

405 Hilgard Avenue
Box 951361
Los Angeles, CA 90095
United States

Ann H. Partridge

Harvard University - Dana-Farber Cancer Institute ( email )

Fabrice André

Gustave Roussy Cancer Campus ( email )

114 Rue Edouard Vaillant
94800 Villejuif
France

Stefan Michiels

University of Paris-Saclay ( email )

55 Avenue de Paris
Versailles, 78000
France

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