Quality of Life Research

, Volume 16, Issue 6, pp 947–960 | Cite as

Fatigue in breast cancer survivors two to five years post diagnosis: a HEAL Study report

  • Kathleen Meeske
  • Ashley Wilder Smith
  • Catherine M. Alfano
  • Bonnie A. McGregor
  • Anne McTiernan
  • Kathy B. Baumgartner
  • Kathleen E. Malone
  • Bryce B. Reeve
  • Rachel Ballard-Barbash
  • Leslie Bernstein


Purpose The purpose of this study was to estimate prevalence of fatigue, identify correlates of fatigue and evaluate the relationship between fatigue and health-related quality of life (HRQOL) in a large cohort of disease-free breast cancer survivors.

Methods Participants are enrolled in the HEAL Study, a multi-center prospective study of women diagnosed with in-situ to Stage IIIA breast cancer. HEAL participants (n = 1183) completed a baseline and a 24-month follow-up interview. Women in this report (n = 800) also completed a quality of life questionnaire that included the Piper Fatigue Scale and the RAND SF-36 two to five years after diagnosis. Multivariate regression methods were used to identify significant factors associated with fatigue. SF-36 scores for fatigued survivors were compared to non-fatigued survivor scores and population norms.

Results Forty-one percent of the breast cancer survivors were fatigued. Significant correlates of fatigue included pain, cognitive problems, physical inactivity, weight gain/personal appearance and antidepressant use. Fatigue was associated with poorer HRQOL, most notably in areas of role and social functioning.

Conclusion This study provides further support for the conclusion that a significant proportion of breast cancer survivors experience fatigue that compromises HRQOL two to five years post-diagnosis.


Breast cancer survivors Fatigue Quality of life Piper Fatigue Scale 



Health-Related Quality Of Life


Quality Of Life


Surveillance, Epidemiology and End Results


Health, Eating, Activity and Lifestyle


Odds Ratio


Revised-Piper Fatigue Scale


Breast Cancer Prevention Trial


Hormone-related Symptom Checklist


Short Form-36


Standard deviation



This study was supported by NCI contracts N01-CN-75036-20, N01-CN-05228, N01-PC-67010 and a training grant T32 CA90661 that supports Dr. Meeske. Data collection for the Women’s CARE Study at the University of Southern California was supported by contract N01-HD-3-3175 from the National Institute of Child Health and Human Development and patient identification was supported in part by contract 050Q-8709-S1528 from the California Department of Health Services.


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Copyright information

© Springer Science+Business Media B.V. 2007

Authors and Affiliations

  • Kathleen Meeske
    • 1
  • Ashley Wilder Smith
    • 2
  • Catherine M. Alfano
    • 3
  • Bonnie A. McGregor
    • 4
  • Anne McTiernan
    • 4
  • Kathy B. Baumgartner
    • 5
  • Kathleen E. Malone
    • 4
  • Bryce B. Reeve
    • 2
  • Rachel Ballard-Barbash
    • 2
  • Leslie Bernstein
    • 1
  1. 1.Department of Preventive MedicineKeck School of Medicine of the University of Southern California, USC/Norris Comprehensive Cancer CenterLos AngelesUSA
  2. 2.Outcomes Research Branch, Applied Research Program, Division of Cancer Control and Population SciencesNational Cancer Institute, EPN 4005BethesdaUSA
  3. 3.College of Public Health and Comprehensive Cancer CenterThe Ohio State UniversityColumbusUSA
  4. 4.Fred Hutchinson Cancer Research CenterSeattleUSA
  5. 5.Epidemiology and Clinical Investigation Sciences, School of Public Health & Information SciencesUniversity of LouisvilleLouisvilleUSA

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