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

Vaz-Luís, Inês; Meglio, Antonio Di; Havas, Julie; El-Mouhebb, Mayssam; Lapidari, Pietro; Presti, Daniele; Soldato, Davide; Pistilli, Barbara; Dumas, Agnès; Menvielle, Gwenn; Everhard, Sibille; Martin, Anne‐Laure; Cottu, Paul‐Henri; Lerebours, Florence; Coutant, Charles; Dauchy, Sarah; Delaloge, Suzette; Lin, Nancy U.; Ganz, Patricia A.; Partridge, Ann H.; Varga, Andrea; Michiels, Stefan

doi:10.1200/jco.21.01958

Cited by 25 publications

(21 citation statements)

References 45 publications

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“…Changes in contraceptive use over time were evaluated using the Cochrane-Armitage trend test. An initial working set of variables potentially associated with contraceptive use was chosen based on background clinical knowledge [25][26][27][28][29] (Table 1). We then used descriptive statistics to summarize cohort characteristics by use of contraception at year 1 and year 2, with χ 2 tests used for categorical variables and t tests used for continuous variables (eTable 1 and eTable 2 in the Supplement).…”

Section: Discussionmentioning

confidence: 99%

“…A standard scoring algorithm was used to convert responses to a scale of 0 to 100 points, with higher scores indicating better function. Fatigue was assessed using the fatigue symptom scale of the EORTC QLQ-C30 [27][28][29] ; a standard scoring algorithm was used to convert responses to a scale of 0 to 100, with higher scores indicating greater severity of fatigue. Scores of 40 points or greater were categorized as severe.…”

Section: Data Sourcementioning

confidence: 99%

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Contraceptive Use in Premenopausal Women With Early Breast Cancer

et al. 2022

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ImportanceAs life span has increased among patients with cancer, survivorship has become an important component of breast cancer care. Among survivorship concerns, adequate contraceptive counseling is needed for premenopausal patients who are not seeking to become pregnant.ObjectiveTo examine contraceptive use and chosen methods and to assess factors associated with contraceptive use over time in patients with early breast cancer.Design, Setting, and ParticipantsThe Cancer Toxicity (CANTO) study was a multicenter nationwide prospective cohort study that enrolled women diagnosed with stage I to stage III breast cancer in France between March 2012 and December 2017. This analysis included 2900 premenopausal women who were 50 years of age or younger at diagnosis. Data were analyzed from July 2020 to July 2022.ExposuresContraceptive use and method at diagnosis, shortly after the end of primary treatment (year 1), and during follow-up (year 2).Main Outcomes and MeasuresContraceptive use and methods were longitudinally evaluated at diagnosis, year 1, and year 2 after breast cancer diagnosis. Multivariable logistic regression models were used to assess the associations of clinical, socioeconomic, treatment, adverse effect, and patient-reported outcome variables with contraceptive use after diagnosis.ResultsA total of 2900 patients (mean [SD] age, 43.1 [5.6] years) were included in the analysis; 2050 of 2894 women (70.8%) received chemotherapy, and 2305 of 2880 women (80.0%) received endocrine therapy. After diagnosis, 1182 of 2625 patients (45.0%) at year 1 and 1553 of 2363 patients (65.7%) at year 2 reported consulting with a gynecologist in the previous year. At diagnosis, 1487 of 2744 patients (54.2%) reported contraceptive use, with most patients (921 of 1470 women [62.7%]) using hormonal methods. The use of contraception significantly decreased after diagnosis (911 of 2342 patients [38.9%] at year 1 and 808 of 1961 patients [41.2%] at year 2; P &lt; .001 for trend), when most patients (848 of 900 women [94.2%] at year 1 and 767 of 805 women [95.3%] at year 2) reported use of nonhormonal methods; these methods were primarily reversible mechanical approaches (copper intrauterine devices: 656 of 848 patients [77.4%] at year 1 and 577 of 767 patients [75.2%] at year 2; male condoms: 115 of 848 patients [13.6%] at year 1 and 110 of 767 patients [14.3%] at year 2). In the multivariable model, factors significantly associated with contraceptive use at year 1 included using contraception at diagnosis (adjusted odds ratio [aOR], 4.02; 95% CI, 3.15-5.14), being younger (aOR, 1.09; 95% CI, 1.07-1.13 per decreasing year), having better sexual function (aOR, 1.13; 95% CI, 1.07-1.19 per 10-point increment), having children (aOR, 4.21; 95% CI, 1.80-9.86), reporting the presence of leukorrhea (aOR, 1.32; 95% CI, 1.03-1.70), receiving tamoxifen treatment alone (aOR, 1.39; 95% CI, 1.01-1.92), and consulting with a gynecologist in the previous year (aOR, 1.29; 95% CI, 1.02-1.63). Similar factors were associated with contraceptive use at year 2, with the addition of partnered status (aOR, 1.61; 95% CI, 1.07-2.44).Conclusions and RelevanceFindings from this study support the importance of raising awareness and improving targeted contraceptive counseling for premenopausal women with early breast cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Data Sourcementioning

confidence: 99%

Contraceptive Use in Premenopausal Women With Early Breast Cancer

et al. 2022

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“…Among the different symptom scales, baseline fatigue was significantly associated with PCTs. Fatigue is the most common reported effect of BC treatment, and baseline fatigue has been also associated with chronic fatigue at 2 years' follow-up [48][49][50] During cancer treatment, such as radiotherapy and/or chemotherapy, the prevalence rates of fatigue are up to 99%. 51 Fatigue affects other aspects of patient well-being and has been indicated as a major contributor to overall QoL.…”

Section: Discussionmentioning

confidence: 99%

Baseline quality of life and chemotherapy toxicities in patients with early breast cancer

Licaj

Coquan

Dabakuyo‐Yonli

et al. 2023

Cancer

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“…37 Although longitudinal studies suggest fatigue as a better predictor of depression than vice versa, 38 as well as of other symptoms such as insomnia and pain, 39 the association between fatigue and depression still seems to be bidirectional, albeit with different predictive power. 34 Beside chemotherapy, also RT From the studies evaluating latent fatigue trajectories in breast cancer patients, [16][17][18][19][20]40 only one study used the MFI-20 to measure fatigue levels over time. 16 marital status, depression, pain and insomnia were significantly associated with a higher risk of belonging to the high fatigue trajectory, from which depression, pain and insomnia were consistent with our findings.…”

Section: Discussionmentioning

confidence: 99%

(Pre)treatment risk factors for late fatigue and fatigue trajectories following radiotherapy for breast cancer

Rosas

Aguado-Barrera

Azria

et al. 2023

Intl Journal of Cancer

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Fatigue is common in breast‐cancer survivors. Our study assessed fatigue longitudinally in breast cancer patients receiving adjuvant radiotherapy (RT) and aimed to identify risk factors associated with long‐term fatigue and underlying fatigue trajectories. Fatigue was measured in a prospective multicenter cohort (REQUITE) using the Multidimensional Fatigue Inventory (MFI‐20) and analyzed using mixed models. Multivariable logistic models identified factors associated with fatigue dimensions at 2 years post‐RT and latent class growth analysis identified individual fatigue trajectories. A total of 1443, 1302, 1203 and 1098 patients completed the MFI‐20 at baseline, end of RT, after 1 and 2 years. Overall, levels of fatigue significantly increased from baseline to end of RT for all fatigue dimensions (P < .05) and returned to baseline levels after 2 years. A quarter of patients were assigned to latent trajectory high (23.7%) and moderate (24.8%) fatigue classes, while 46.3% and 5.2% to the low and decreasing fatigue classes, respectively. Factors associated with multiple fatigue dimensions at 2 years include age, BMI, global health status, insomnia, pain, dyspnea and depression. Fatigue present at baseline was consistently associated with all five MFI‐20 fatigue dimensions (ORGeneralFatigue = 3.81, P < .001). From latent trajectory analysis, patients with a combination of factors such as pain, insomnia, depression, younger age and endocrine therapy had a particularly high risk of developing early and persistent high fatigue years after treatment. Our results confirmed the multidimensional nature of fatigue and will help clinicians identify breast cancer patients at higher risk of having persistent/late fatigue so that tailored interventions can be delivered.

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

Cited by 25 publications

References 45 publications

Contraceptive Use in Premenopausal Women With Early Breast Cancer

Contraceptive Use in Premenopausal Women With Early Breast Cancer

Baseline quality of life and chemotherapy toxicities in patients with early breast cancer

(Pre)treatment risk factors for late fatigue and fatigue trajectories following radiotherapy for breast cancer

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