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@ARTICLE{Schmidt:127462,
      author       = {M. Schmidt$^*$ and J. Chang-Claude$^*$ and P. Seibold$^*$
                      and A. Vrieling$^*$ and J. Heinz and D. Flesch-Janys and K.
                      Steindorf$^*$},
      title        = {{D}eterminants of long-term fatigue in breast cancer
                      survivors: results of a prospective patient cohort study.},
      journal      = {Psycho-oncology},
      volume       = {24},
      number       = {1},
      issn         = {1057-9249},
      address      = {New York, NY [u.a.]},
      publisher    = {Wiley},
      reportid     = {DKFZ-2017-03485},
      pages        = {40 - 46},
      year         = {2015},
      abstract     = {Fatigue is among the most distressing symptoms across the
                      breast cancer continuum. However, little is known about the
                      factors contributing to long-term persisting fatigue.
                      Therefore, we explored determinants of long-term physical,
                      affective, and cognitive fatigue in a prospective cohort of
                      breast cancer patients.Breast cancer patients recruited in a
                      population-based case-control study (MARIE study) provided
                      comprehensive data on sociodemographics, lifestyle, and
                      preexisting medical conditions. At follow-up (median 6.3
                      years post-diagnosis, MARIEplus), disease-free cancer
                      survivors (N = 1928) reported current fatigue using a
                      validated multidimensional questionnaire. Additionally,
                      survivors retrospectively rated their fatigue levels before
                      diagnosis, during the treatment phase, and 1 year
                      post-surgery. Linear regression analyses were performed.As
                      major determinants of long-term physical, affective, and
                      cognitive fatigue, multiple regression analyses revealed
                      preexisting psychological or depressive disorders, migraine,
                      analgesic use, peripheral arterial obstructive disease
                      (PAOD), and arthritis. A physically inactive lifestyle and
                      obesity were associated with persisting physical fatigue.
                      Aromatase inhibitors were also associated with long-term
                      fatigue, especially cognitive fatigue. Chemotherapy and, to
                      a lower extent, radiotherapy were major contributors to the
                      development of fatigue during the treatment phase, yet were
                      not associated with long-term fatigue.Although the
                      development of fatigue in breast cancer patients seems
                      largely impacted by cancer therapy, for the long-term
                      persistence of fatigue, preexisting medical or psychological
                      conditions related to depression or pain and lifestyle
                      factors appear to be more relevant. Physicians,
                      psycho-oncologists, and researchers may need to distinguish
                      between acute fatigue during therapy and long-term
                      persisting fatigue with regard to its pathophysiology and
                      treatment.},
      keywords     = {Analgesics (NLM Chemicals) / Antineoplastic Agents (NLM
                      Chemicals) / Aromatase Inhibitors (NLM Chemicals)},
      cin          = {G110 / C020 / G111},
      ddc          = {150},
      cid          = {I:(DE-He78)G110-20160331 / I:(DE-He78)C020-20160331 /
                      I:(DE-He78)G111-20160331},
      pnm          = {317 - Translational cancer research (POF3-317)},
      pid          = {G:(DE-HGF)POF3-317},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:24839264},
      doi          = {10.1002/pon.3581},
      url          = {https://inrepo02.dkfz.de/record/127462},
}