{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:49:14Z","timestamp":1787068154544,"version":"build-2736575974"},"reference-count":65,"publisher":"American Medical Association (AMA)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Patients with breast cancer (BC) may have long-term fatigue after treatment, which is associated with reduced quality of life.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To identify cardiac, psychological, and cancer treatment factors associated with fatigue before and 24 months after BC treatment.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This cohort study was conducted across multiple community hospital-based cancer centers among participants with stage I to III BC receiving potentially cardiotoxic chemotherapy or aromatase inhibitors and noncancer comparators. Participants were enrolled from May 2017 to July 2021 and followed up for 24 months. Data were analyzed between July 2023 and July 2026.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n Fatigue was assessed by the Functional Assessment of Chronic Illness Therapy Fatigue scale.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n It was hypothesized that chemotherapy-associated changes in left ventricular function were associated with and mediated 2-year post-BC treatment fatigue. Outcome measures included fatigue, sociodemographic variables, hematocrit, left ventricular ejection fraction and circumferential strain, cardiovascular comorbidities, 6-minute walk distance, perceived stress, and depressive symptoms.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n From a total of 381 patients, patients with BC (236) and noncancer comparators (145) had a mean (SD) age of 54 (12) years. Two years after BC treatment, 33 (18.2%) receiving potentially cardiotoxic chemotherapy experienced clinically relevant fatigue (\u03c7\n 2<\/jats:sup>\n test\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001 relative to aromatase inhibitors or controls), and 62 (34.6%) experienced a significant increase in fatigue relative to their precancer treatment fatigue level (\u03c7\n 2<\/jats:sup>\n test\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001, relative to aromatase inhibitors and controls). Independent of pretreatment and posttreatment left ventricular ejection fraction, diabetes status, hypertension, tobacco use, age, body mass index, hematocrit, receipt of potentially cardioprotective medications, and chemotherapy regimens, only depressive symptoms (estimate, \u22120.77; 95% CI, \u22120.83 to \u22120.71;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001) and perceived stress (\u22120.32; 95% CI, \u22120.41 to \u22120.24;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001) were associated with and mediated 24-month post-BC treatment fatigue measures. Baseline adjusted changes in 6-minute walk distance, left ventricular ejection fraction, and left ventricular strain were not associated with 24-month post-BC treatment fatigue levels.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this cohort study of patients with BC, clinically relevant fatigue increased in 34% of patients 2 years after initiating cancer treatment mediated partly by depressive symptoms and perceived stress regardless of cardiovascular risk factors, age, or change in left ventricular ejection fraction and\/or strain.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n ClinicalTrials.gov Identifier:\n NCT02791581<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.29862","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:05:06Z","timestamp":1787065506000},"page":"e2629862","source":"Crossref","is-referenced-by-count":0,"title":["Long-Term Fatigue After Treatment for Breast Cancer"],"prefix":"10.1001","volume":"9","author":[{"given":"Nancy E.","family":"Avis","sequence":"first","affiliation":[{"name":"Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Medical Center Blvd., Winston-Salem, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathaniel S.","family":"O\u2019Connell","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon L.","family":"Mihalko","sequence":"additional","affiliation":[{"name":"Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Medical Center Blvd., Winston-Salem, North Carolina"},{"name":"Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer H.","family":"Jordan","sequence":"additional","affiliation":[{"name":"VCU Pauley Heart Center, Division of Cardiology at Virginia Commonwealth University, Richmond"},{"name":"Department of Biomedical Engineering, Virginia Commonwealth University, Richmond"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy C.","family":"Ladd","sequence":"additional","affiliation":[{"name":"VCU Pauley Heart Center, Division of Cardiology at Virginia Commonwealth University, Richmond"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glenn J.","family":"Lesser","sequence":"additional","affiliation":[{"name":"Department of Cancer Medicine at Wake Forest School of Medicine, Winston-Salem, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristine C.","family":"Olson","sequence":"additional","affiliation":[{"name":"VCU Pauley Heart Center, Division of Cardiology at Virginia Commonwealth University, Richmond"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn E.","family":"Weaver","sequence":"additional","affiliation":[{"name":"Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Medical Center Blvd., Winston-Salem, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily V.","family":"Dressler","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela J.","family":"Grizzard","sequence":"additional","affiliation":[{"name":"VCU Pauley Heart Center, Division of Cardiology at Virginia Commonwealth University, Richmond"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beverly","family":"Levine","sequence":"additional","affiliation":[{"name":"Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Medical Center Blvd., Winston-Salem, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tonya L.","family":"Moore","sequence":"additional","affiliation":[{"name":"Section on Cardiovascular Medicine, Department of Internal Medicine at Wake Forest School of Medicine, Winston-Salem, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bonnie","family":"Ky","sequence":"additional","affiliation":[{"name":"Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Helen","family":"Hackney","sequence":"additional","affiliation":[{"name":"Department of Hematology, Oncology, and Palliative Care, Massey Cancer Center, Virginia Commonwealth University, Richmond"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Brubaker","sequence":"additional","affiliation":[{"name":"Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerryn W.","family":"Reding","sequence":"additional","affiliation":[{"name":"University of Washington School of Nursing, University of Washington, Seattle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander R.","family":"Lucas","sequence":"additional","affiliation":[{"name":"Department of Social and Behavioral Sciences, Virginia Commonwealth University School of Public Health, Richmond"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moriah P.","family":"Bellissimo","sequence":"additional","affiliation":[{"name":"VCU Pauley Heart Center, Division of Cardiology at Virginia Commonwealth University, Richmond"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F. Gerard","family":"Moeller","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Virginia Commonwealth University, Richmond"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dalane W.","family":"Kitzman","sequence":"additional","affiliation":[{"name":"Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina"},{"name":"Department of Cardiovascular Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig A.","family":"Hamilton","sequence":"additional","affiliation":[{"name":"Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi D.","family":"Klepin","sequence":"additional","affiliation":[{"name":"Department of Cancer Medicine at Wake Forest School of Medicine, Winston-Salem, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Yeboah","sequence":"additional","affiliation":[{"name":"Section on Cardiovascular Medicine, Department of Internal Medicine at Wake Forest School of Medicine, Winston-Salem, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Ntim","sequence":"additional","affiliation":[{"name":"University of North Carolina School of Medicine, Novant Health Campus, Novant Heart and Vascular Institute, Charlotte"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vlad G.","family":"Zaha","sequence":"additional","affiliation":[{"name":"Harold CSimmons Comprehensive Cancer Center, Dallas, Texas; Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Ralph","family":"D\u2019Agostino","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. Gregory","family":"Hundley","sequence":"additional","affiliation":[{"name":"VCU Pauley Heart Center, Division of Cardiology at Virginia Commonwealth University, Richmond"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2026,8,18]]},"reference":[{"issue":"4","key":"zoi260819r1","doi-asserted-by":"publisher","first-page":"S36","DOI":"10.12968\/bjon.2021.30.4.S36","article-title":"Cancer-related fatigue: an overview.","volume":"30","author":"Al Maqbali","year":"2021","journal-title":"Br J Nurs"},{"issue":"8","key":"zoi260819r2","doi-asserted-by":"publisher","first-page":"528","DOI":"10.1007\/s00520-024-08717-7","article-title":"The impact of non- and anthracycline-based chemotherapy on fatigue in breast cancer survivors: results from WF-97415.","volume":"32","author":"Avis","year":"2024","journal-title":"Support Care Cancer"},{"issue":"6","key":"zoi260819r3","doi-asserted-by":"publisher","first-page":"965","DOI":"10.1093\/annonc\/mdw099","article-title":"Risk factors, prevalence, and course of severe fatigue after breast cancer treatment: a meta-analysis involving 12 327 breast cancer survivors.","volume":"27","author":"Abrahams","year":"2016","journal-title":"Ann Oncol"},{"issue":"33","key":"zoi260819r4","doi-asserted-by":"publisher","first-page":"8296","DOI":"10.1200\/JCO.2005.10.167","article-title":"Fatigue and relating factors in high-risk breast cancer patients treated with adjuvant standard or high-dose chemotherapy: a longitudinal study.","volume":"23","author":"Nieboer","year":"2005","journal-title":"J Clin Oncol"},{"issue":"3","key":"zoi260819r5","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1016\/j.jamcollsurg.2009.11.015","article-title":"A community cancer center program: getting to the next level.","volume":"210","author":"Petrelli","year":"2010","journal-title":"J Am Coll Surg"},{"issue":"9","key":"zoi260819r6","doi-asserted-by":"publisher","first-page":"1303","DOI":"10.1001\/jamaoncol.2015.3151","article-title":"Risk adjusting survival outcomes in hospitals that treat patients with cancer without information on cancer stage.","volume":"1","author":"Pfister","year":"2015","journal-title":"JAMA Oncol"},{"issue":"2","key":"zoi260819r7","doi-asserted-by":"publisher","first-page":"93","DOI":"10.3322\/caac.21388","article-title":"The Eighth Edition AJCC Cancer Staging Manual: continuing to build a bridge from a population-based to a more \u201cpersonalized\u201d approach to cancer staging.","volume":"67","author":"Amin","year":"2017","journal-title":"CA Cancer J Clin"},{"key":"zoi260819r8","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1200\/JOP.2015.005736","article-title":"ReCAP: impact of the National Cancer Institute Community Cancer Centers program on clinical trial and related activities at a community cancer center in rural Nebraska.","volume":"12","author":"Copur","year":"2016","journal-title":"JOP"},{"issue":"2","key":"zoi260819r9","doi-asserted-by":"publisher","first-page":"632","DOI":"10.1245\/s10434-020-08867-y","article-title":"Improving the quality of cancer care in community hospitals.","volume":"28","author":"Tucker","year":"2021","journal-title":"Ann Surg Oncol"},{"issue":"1","key":"zoi260819r10","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1016\/j.jaccao.2020.02.013","article-title":"Fatigue, cardiovascular decline, and events after breast cancer treatment: rationale and design of UPBEAT study.","volume":"2","author":"Jordan","year":"2020","journal-title":"JACC CardioOncol"},{"issue":"6","key":"zoi260819r11","doi-asserted-by":"publisher","first-page":"649","DOI":"10.1097\/00000421-198212000-00014","article-title":"Toxicity and response criteria of the Eastern Cooperative Oncology Group.","volume":"5","author":"Oken","year":"1982","journal-title":"Am J Clin Oncol"},{"issue":"1","key":"zoi260819r13","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1093\/aje\/kws421","article-title":"Factors related to age at natural menopause: longitudinal analyses from SWAN.","volume":"178","author":"Gold","year":"2013","journal-title":"Am J Epidemiol"},{"key":"zoi260819r15","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1186\/1477-7525-1-79","article-title":"The Functional Assessment of Chronic Illness Therapy (FACIT) measurement system: properties, applications, and interpretation.","volume":"1","author":"Webster","year":"2003","journal-title":"Health Qual Life Outcomes"},{"issue":"2","key":"zoi260819r16","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1016\/S0885-3924(96)00274-6","article-title":"Measuring fatigue and other anemia-related symptoms with the Functional Assessment of Cancer Therapy (FACT) measurement system.","volume":"13","author":"Yellen","year":"1997","journal-title":"J Pain Symptom Manage"},{"issue":"8","key":"zoi260819r17","doi-asserted-by":"publisher","first-page":"958","DOI":"10.6004\/jnccn.2010.0070","article-title":"Cancer-related fatigue: definitions and clinical subtypes.","volume":"8","author":"Piper","year":"2010","journal-title":"J Natl Compr Canc Netw"},{"issue":"1","key":"zoi260819r18","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1186\/s41687-023-00609-4","article-title":"Clinically important change for the FACIT-Fatigue scale in paroxysmal nocturnal hemoglobinuria: a derivation from international PNH registry patient data.","volume":"7","author":"Cella","year":"2023","journal-title":"J Patient Rep Outcomes"},{"issue":"25","key":"zoi260819r19","doi-asserted-by":"publisher","first-page":"2575","DOI":"10.1161\/CIRCULATIONAHA.117.027930","article-title":"Early myocardial strain changes during potentially cardiotoxic chemotherapy may occur as a result of reductions in left ventricular end-diastolic volume: the need to interpret left ventricular strain with volumes.","volume":"135","author":"Jordan","year":"2017","journal-title":"Circulation"},{"issue":"4","key":"zoi260819r20","doi-asserted-by":"publisher","first-page":"271","DOI":"10.3109\/10976640009148691","article-title":"Reduction in sample size for studies of remodeling in heart failure by the use of cardiovascular magnetic resonance.","volume":"2","author":"Bellenger","year":"2000","journal-title":"J Cardiovasc Magn Reson"},{"issue":"25","key":"zoi260819r21","doi-asserted-by":"publisher","first-page":"2653","DOI":"10.1016\/j.jacc.2012.08.1010","article-title":"6-min walk test provides prognostic utility comparable to cardiopulmonary exercise testing in ambulatory outpatients with systolic heart failure.","volume":"60","author":"Forman","year":"2012","journal-title":"J Am Coll Cardiol"},{"issue":"2","key":"zoi260819r22","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1016\/S0749-3797(18)30622-6","article-title":"Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale).","volume":"10","author":"Andresen","year":"1994","journal-title":"Am J Prev Med"},{"issue":"4","key":"zoi260819r23","doi-asserted-by":"publisher","first-page":"385","DOI":"10.2307\/2136404","article-title":"A global measure of perceived stress.","volume":"24","author":"Cohen","year":"1983","journal-title":"J Health Soc Behav"},{"issue":"3","key":"zoi260819r25","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1093\/biomet\/63.3.581","article-title":"Inference and missing data.","volume":"63","author":"Rubin","year":"1976","journal-title":"Biometrika"},{"issue":"3","key":"zoi260819r26","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v045.i03","article-title":"mice: multivariate imputation by chained equations in R.","volume":"45","author":"van Buuren","year":"2011","journal-title":"Journal of Statistical Software"},{"issue":"1","key":"zoi260819r27","doi-asserted-by":"publisher","first-page":"1","DOI":"10.4172\/2155-6180.1000334","article-title":"Methods for analysis of pre-post data in clinical research: a comparison of five common methods.","volume":"8","author":"O\u2019Connell","year":"2017","journal-title":"J Biom Biostat"},{"issue":"1","key":"zoi260819r28","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v033.i01","article-title":"Regularization paths for generalized linear models via coordinate descent.","volume":"33","author":"Friedman","year":"2010","journal-title":"J Stat Softw"},{"issue":"4","key":"zoi260819r29","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1002\/(SICI)1097-0258(19970228)16:4<385::AID-SIM380>3.0.CO;2-3","article-title":"The LASSO method for variable selection in the Cox model.","volume":"16","author":"Tibshirani","year":"1997","journal-title":"Stat Med"},{"issue":"2","key":"zoi260819r30","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18637\/jss.v048.i02","article-title":"lavaan: an R package for structural equation modeling.","volume":"48","author":"Rosseel","year":"2012","journal-title":"J Stat Softw"},{"key":"zoi260819r31","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1146\/annurev.psych.60.110707.163612","article-title":"Latent variable modeling of differences and changes with longitudinal data.","volume":"60","author":"McArdle","year":"2009","journal-title":"Annu Rev Psychol"},{"issue":"2-3","key":"zoi260819r32","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1080\/15427600902911247","article-title":"Mediation models for longitudinal data in developmental research.","volume":"6","author":"Selig","year":"2009","journal-title":"Res Hum Dev"},{"issue":"2","key":"zoi260819r33","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1080\/10705511.2012.659627","article-title":"Recent changes leading to subsequent changes: extensions of multivariate latent difference score models.","volume":"19","author":"Grimm","year":"2012","journal-title":"Struct Equ Modeling"},{"issue":"9","key":"zoi260819r34","doi-asserted-by":"crossref","first-page":"1579","DOI":"10.1002\/ijc.34640","article-title":"(Pre)treatment risk factors for late fatigue and fatigue trajectories following radiotherapy for breast cancer.","volume":"153","author":"Rosas","year":"2023","journal-title":"Int J Cancer"},{"issue":"8","key":"zoi260819r35","doi-asserted-by":"crossref","first-page":"1334","DOI":"10.1002\/cncr.33327","article-title":"Do all patients with cancer experience fatigue? A longitudinal study of fatigue trajectories in women with breast cancer.","volume":"127","author":"Bower","year":"2021","journal-title":"Cancer"},{"issue":"2","key":"zoi260819r37","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.119.015400","article-title":"Simultaneous left ventricular volume and strain changes during chemotherapy associate with 2-year postchemotherapy measures of left ventricular ejection fraction.","volume":"9","author":"Suerken","year":"2020","journal-title":"J Am Heart Assoc"},{"issue":"3","key":"zoi260819r38","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1007\/s12012-019-09556-3","article-title":"Impact of arterial hypertension on doxorubicin-based chemotherapy-induced subclinical cardiac damage in breast cancer patients.","volume":"20","author":"Vaitiekus","year":"2020","journal-title":"Cardiovasc Toxicol"},{"issue":"5","key":"zoi260819r39","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1161\/CIRCIMAGING.112.973321","article-title":"Assessment of echocardiography and biomarkers for the extended prediction of cardiotoxicity in patients treated with anthracyclines, taxanes, and trastuzumab.","volume":"5","author":"Sawaya","year":"2012","journal-title":"Circ Cardiovasc Imaging"},{"key":"zoi260819r40","article-title":"Statins and left ventricular ejection fraction following doxorubicin treatment.","author":"Hundley","journal-title":"NEJM Evid"},{"issue":"6","key":"zoi260819r41","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.1161\/HYPERTENSIONAHA.123.21817","article-title":"Hypertension severity and declines in left ventricular ejection fraction among women receiving adjuvant chemotherapy for breast cancer (WF-97415 UPBEAT).","volume":"81","author":"Garg","year":"2024","journal-title":"Hypertension"},{"issue":"11","key":"zoi260819r42","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1037\/hea0000652","article-title":"Fatigue after breast cancer treatment: Biobehavioral predictors of fatigue trajectories.","volume":"37","author":"Bower","year":"2018","journal-title":"Health Psychol"},{"issue":"11","key":"zoi260819r43","doi-asserted-by":"crossref","DOI":"10.1002\/cam4.7293","article-title":"Prevalence and biopsychosocial indicators of fatigue in cancer patients.","volume":"13","author":"Zeilinger","year":"2024","journal-title":"Cancer Med"},{"issue":"1","key":"zoi260819r44","doi-asserted-by":"crossref","DOI":"10.1002\/cam4.70404","article-title":"Pretreatment fatigue in breast cancer patients: comparison with healthy controls and associations with biopsychosocial variables.","volume":"14","author":"Blickle","year":"2025","journal-title":"Cancer Med"},{"issue":"1","key":"zoi260819r45","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.jpainsymman.2020.07.019","article-title":"Higher levels of stress are associated with a significant symptom burden in oncology outpatients receiving chemotherapy.","volume":"61","author":"Jakovljevic","year":"2021","journal-title":"J Pain Symptom Manage"},{"issue":"3","key":"zoi260819r46","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1002\/smi.2548","article-title":"Association of fatigue with perceived stress in chinese women with early stage breast cancer awaiting adjuvant radiotherapy.","volume":"31","author":"Ho","year":"2015","journal-title":"Stress Health"},{"issue":"10","key":"zoi260819r47","first-page":"4697","article-title":"Higher levels of stress and different coping strategies are associated with greater morning and evening fatigue severity in oncology patients receiving chemotherapy.","volume":"28","author":"Wright","year":"2020","journal-title":"Support Care Cancer"},{"issue":"7","key":"zoi260819r48","doi-asserted-by":"crossref","first-page":"e401","DOI":"10.1016\/j.clbc.2023.06.005","article-title":"Psychological coping factors associated with breast cancer-related fatigue: a systematic review of recent evidence for stages 0 to III.","volume":"23","author":"Schaab","year":"2023","journal-title":"Clin Breast Cancer"},{"issue":"3","key":"zoi260819r49","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1016\/j.jpainsymman.2019.10.025","article-title":"Distinct stress profiles among oncology patients undergoing chemotherapy.","volume":"59","author":"Langford","year":"2020","journal-title":"J Pain Symptom Manage"},{"issue":"3","key":"zoi260819r50","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1002\/pon.736","article-title":"Depressive symptoms after breast cancer surgery: relationships with global, cancer-related, and life event stress.","volume":"13","author":"Golden-Kreutz","year":"2004","journal-title":"Psychooncology"},{"issue":"15","key":"zoi260819r51","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.1200\/JCO.2013.52.4611","article-title":"Screening, assessment, and care of anxiety and depressive symptoms in adults with cancer: an American Society of Clinical Oncology guideline adaptation.","volume":"32","author":"Andersen","year":"2014","journal-title":"J Clin Oncol"},{"issue":"7","key":"zoi260819r52","doi-asserted-by":"crossref","first-page":"1787","DOI":"10.1002\/pon.4728","article-title":"Life stress and symptoms of anxiety and depression in women after cancer: The mediating effect of stress appraisal and coping.","volume":"27","author":"Seib","year":"2018","journal-title":"Psychooncology"},{"issue":"3","key":"zoi260819r53","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1002\/cncr.31790","article-title":"The role of neuro-immune interactions in cancer-related fatigue: biobehavioral risk factors and mechanisms.","volume":"125","author":"Bower","year":"2019","journal-title":"Cancer"},{"issue":"3","key":"zoi260819r54","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1177\/2156587216676122","article-title":"Cancer and cancer-related fatigue and the interrelationships with depression, stress, and inflammation.","volume":"22","author":"Weber","year":"2017","journal-title":"J Evid Based Complementary Altern Med"},{"issue":"17","key":"zoi260819r55","doi-asserted-by":"crossref","first-page":"1840","DOI":"10.1200\/JCO.2013.53.4495","article-title":"Screening, assessment, and management of fatigue in adult survivors of cancer: an American Society of Clinical oncology clinical practice guideline adaptation.","volume":"32","author":"Bower","year":"2014","journal-title":"J Clin Oncol"},{"issue":"5","key":"zoi260819r56","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1016\/j.jaccao.2022.12.011","article-title":"Physical activity during breast cancer therapy associates with preserved exercise capacity and cardiac function (WF97415).","volume":"5","author":"Bellissimo","year":"2023","journal-title":"JACC CardioOncol"},{"issue":"11","key":"zoi260819r57","doi-asserted-by":"crossref","first-page":"1789","DOI":"10.1158\/1055-9965.EPI-15-0327","article-title":"Trajectories of depressive symptoms following breast cancer diagnosis.","volume":"24","author":"Avis","year":"2015","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"issue":"5","key":"zoi260819r58","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1002\/pon.962","article-title":"Differences in patterns of depression after treatment for breast cancer.","volume":"15","author":"Deshields","year":"2006","journal-title":"Psychooncology"},{"issue":"7493","key":"zoi260819r59","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1136\/bmj.38343.670868.D3","article-title":"Depression and anxiety in women with early breast cancer: five year observational cohort study.","volume":"330","author":"Burgess","year":"2005","journal-title":"BMJ"},{"issue":"2","key":"zoi260819r60","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1002\/pon.3409","article-title":"Prevalence of depression in cancer patients: a meta-analysis of diagnostic interviews and self-report instruments.","volume":"23","author":"Krebber","year":"2014","journal-title":"Psychooncology"},{"issue":"5","key":"zoi260819r61","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1200\/JCO.2007.14.3248","article-title":"Behavioral symptoms in patients with breast cancer and survivors.","volume":"26","author":"Bower","year":"2008","journal-title":"J Clin Oncol"},{"issue":"21","key":"zoi260819r62","doi-asserted-by":"crossref","first-page":"1615","DOI":"10.1093\/jnci\/93.21.1615","article-title":"Tamoxifen and depression: more evidence from the National Surgical Adjuvant Breast and Bowel Project\u2019s Breast Cancer Prevention (P-1) Randomized Study.","volume":"93","author":"Day","year":"2001","journal-title":"J Natl Cancer Inst"},{"issue":"14","key":"zoi260819r63","doi-asserted-by":"crossref","first-page":"2101","DOI":"10.1001\/archinte.160.14.2101","article-title":"Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence.","volume":"160","author":"DiMatteo","year":"2000","journal-title":"Arch Intern Med"},{"issue":"2","key":"zoi260819r64","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/j.genhosppsych.2007.10.008","article-title":"Major depression after breast cancer: a review of epidemiology and treatment.","volume":"30","author":"Fann","year":"2008","journal-title":"Gen Hosp Psychiatry"},{"issue":"3","key":"zoi260819r65","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1007\/s11764-013-0286-6","article-title":"Depressive symptoms are a risk factor for all-cause mortality: results from a prospective population-based study among 3,080 cancer survivors from the PROFILES registry.","volume":"7","author":"Mols","year":"2013","journal-title":"J Cancer Surviv"},{"key":"zoi260819r12","unstructured":"Cleveland Clinic. Menopause. 2024. Accessed March 2026. https:\/\/my.clevelandclinic.org\/health\/diseases\/21841-menopause"},{"key":"zoi260819r14","unstructured":"American Heart Association. Home blood pressure monitoring. 2025. Accessed November, 2025. https:\/\/www.heart.org\/en\/health-topics\/high-blood-pressure\/understanding-blood-pressure-readings\/monitoring-your-blood-pressure-at-home"},{"key":"zoi260819r24","unstructured":"R Core Team. R: a language and environment for statistical computing. 2024. Accessed July 7, 2026. https:\/\/www.R-project.org\/"},{"key":"zoi260819r36","unstructured":"American College of Cardiology. New ACC\/AHA high blood pressure guidelines lower definition of hypertension. 2017. Accessed October, 2023. https:\/\/www.acc.org\/latest-in-cardiology\/articles\/2017\/11\/08\/11\/47\/mon-5pm-bp-guideline-aha-2017"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2852964\/avis_2026_oi_260819_1786468851.7743.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:05:17Z","timestamp":1787065517000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2852964"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,18]]},"references-count":65,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8,3]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2026.29862","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,18]]}}}