BACKGROUND: Despite the questionable effectiveness of oral complementary and alternative medicine (OCAM) in relieving cancer-related symptoms, including fatigue (CRF), many patients use it aiming to improve their quality of life.We assessed factors associated with OCAM use, focusing on CRF. METHODS:Women with stage I-III breast cancer (BC) were included from CANTO (NCT01993498). OCAM use was defined as taking homeopathy, vitamins/minerals or herbal/dietary supplements. Multivariable multinomial logistic regressions evaluated associations of CRF (EORTC QLQ-C30), patient, and treatment characteristics with OCAM use. RESULTS:Among 5237 women, 23.0% reported OCAM use overall (49.3% at diagnosis, 50.7% starting postdiagnosis), mostly homeopathy (65.4%). Mean (SD) CRF score was 27.6 (24.0) at diagnosis and 35.1 (25.3) postdiagnosis. More intense CRF was consistently associated with OCAM use at diagnosis and post-diagnosis (adjusted odds

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Vaz-Luis, the Gustave Roussy Foundation to Ines Vaz Luis, and the Philanthropic Odyssea Gustave Roussy Program. We would like to thank Editage (www.editage.com) for English language editing.