Baseline fatigue in early breast cancer survivors: understanding its prevalence in community-based exercise

Purpose Examine baseline fatigue levels in early-breast cancer survivors (EBCS) compared to inactive controls (CON) and identify associated physical and psychosocial factors with fatigue prior to community-based exercise. Methods A total of 33 EBCS (53.9 +/- 11.4 years) and 21 CON (54.0 +/- 8.0 years) were recruited. Participants completed questionnaires for demographics and patient-reported outcome measures pertaining to fatigue, quality of life, mental health, and physical activity, and completed a 6-min walk test, balance assessment, cardiopulmonary exercise test (VO2peak), and muscular strength test. A Mann-Whitney U test compared fatigue between groups and unadjusted univariable linear regressions were used to explore relationships with fatigue. Results Fatigue in EBCS was not statistically different from CON (EBCS: 16.9 +/- 5.75; CON: 14.2 +/- 3.4, p = 0.121). Univariable analyses showed lower fatigue in EBCS was associated with better Physical and Mental Health (both R-2 = 0.435; p < 0.01), better outcome expectations for exercise (R-2 = 0.237; p < 0.01), better self-efficacy (R-2 = 0.407; p < 0.01), lower depression (R-2 = 0.383; p < 0.001), lower anxiety (R-2 = 0.104; p < 0.05), and better balance (R-2 = 0.265; p < 0.01). Lower fatigue in the CON group was associated with better sleep quality (R-2 = 0.263; p < 0.05) and self-efficacy (R-2 = 0.417; p < 0.05). Conclusions Mild fatigue was prevalent in EBCS, whereas moderate/severe fatigue was not. This discrepancy should be explored provided the benefits of exercise for fatigue management. Further, fatigue in EBCS was associated with multiple psychosocial and functional outcomes, which emphasized both its multi-factorial nature and uniqueness to the EBCS population.

Automated summary

The baseline fatigue levels in early-breast cancer survivors were not significantly different from the inactive controls. Fatigue was associated with physical and mental health, exercise expectations, self-efficacy, depression, anxiety, and balance.