How common is fatigue in disease-free breast cancer survivors? A systematic review of the literature

Background There is some debate in the literature as to whether fatigue persists in the long term in women who have completed adjuvant breast cancer treatment. Methods A systematic review was conducted in order to characterise and quantify the phenomenon of post treatment fatigue (PTF). Results There was a wide variation in the measures of fatigue used, duration of follow-up and type of comparison made. Overall 18 studies were identified with a follow-up period of between 4 months and 10 years. Fourteen studies demonstrated the presence of continued PTF and/or differences in fatigue levels compared to a reference population up to 5 years after treatment. One short-term study reported no increase in fatigue at 4 months. Three studies (with an average follow up period of longer than 5 years) did not identify overall quality of life differences in breast cancer survivors when compared with a reference population. However there were significant differences in measures of physical functioning and mental fatigue. Conclusion The authors conclude that there is good evidence of PTF occurring up to 5 years after completion of adjuvant therapy.