Impact of Rehabilitation on Breast Cancer Related Fatigue: A Pilot Study

Abstract

Breast cancer fatigue (BCF) is a complex and multidimensional condition characterized by a persistent sense of physical and/or mental stiffness, resulting in a substantial impairment of health-related quality of life in breast cancer survivors. Aim of this prospective cohort study was to evaluate the feasibility and the effectiveness of a 4-week rehabilitation protocol on BCF, muscle mass, strength, physical performance, and quality of life in breast cancer (BC) survivors. We recruited adult BC women with a diagnosis of BCF, according to the International Classification of Diseases 10 criteria, referred to the Outpatient Service for Oncological Rehabilitation of a University Hospital. All participants performed a specific physical exercise rehabilitative protocol consisting of 60-min sessions repeated 2 times/week for 4 weeks. All outcomes were evaluated at the baseline (T0), at the end of the 4-week rehabilitation treatment (T1), and at 2 months follow up (T2). The primary outcome measure was the Brief Fatigue Inventory (BFI); secondary outcomes included: Fat-Free Mass and Fat Mass, assessed by Bioelectrical Impedance Analysis (BIA); Hand Grip Strength Test (HGS); Short Physical Performance Battery (SPPB); 10-meter walking test (10 MWT); 6-min walking test (6 MWT); European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Thirty-six women (mean age: 55.17 ± 7.76 years) were enrolled in the study. Significant reduction of BCF was observed both after the 4-week rehabilitation treatment (T1) (BFI: 5.4 ± 1.6 vs. 4.2 ± 1.7; p = 0.004) and at the follow-up visit (T2) (BFI: 5.4 ± 1.6 vs. 4.4 ± 1.6; p = 0.004). Moreover, significant differences (p < 0.001) HGS, SPPB, 10 MWT, 6 MWT, and EORTC QLQ-C30 were found at T1, while at T2 all the outcome measures were significantly different (p < 0.05) from the baseline. The rehabilitation protocol seemed to be feasible, safe, and effective in reducing BCF, improving muscle mass and function, and improving HRQoL in a cohort of BC survivors. The results of this study could improve awareness of this underestimated disease, suggesting the definition of a specific therapeutic exercise protocol to reduce BCF.

Rehabilitation interventions to support return to work for women with breast cancer: a systematic review and meta-analysis

“…Lymphoedema, for example, is known to compound RTW challenges where there may be restrictions in mobility or heavy lifting, for example [39]. A multicomponent approach in rehabilitation may help to address wide-ranging disease and treatmentrelated side-effects that impact on RTW [40][41][42].…”

Association of Insomnia, Depressive Disorders, and Mood Disorders as Risk Factors With Breast Cancer: A Nationwide Population-Based Cohort Study of 232,108 Women in Taiwan

“…distress could be alleviated via psychological intervention (7,8). Breast cancerrelated fatigue is also a major issue influencing quality of life, and some rehabilitation protocols like aerobic exercise could help (9). Several studies were focused on prevalence of mental illness during surgical intervention or medical treatment after diagnosing breast cancer since many cases of breast cancer are associated with physical disability and a poor quality of life after their breast cancer diagnosis with symptoms of fatigue, depression, and anxiety (10).…”

The Influence of Rehabilitation on Quality of Life in Breast Cancer Survivors: A Clinical Study

“…The literature indicates that rehabilitation exercise is effective in improving the QoL in patients who have survived cancer [35,36]; in addition, referring to a supervised rehabilitation program for the fatigue reduction [37], there are no studies that have specifically addressed the rehabilitation setting impact and the psycho-emotional implications linked to the patient's personality. Kirkham et al reported how adherence to supervised exercise, delivered in a clinical setting, varies between BC patients and treatments.…”