Impact of early integrated rehabilitation on fatigue in 600 patients with breast cancer - A prospective study


  • Masa Auprih
  • Tina Zagar
  • Nina Kovacevic
  • Andreja Cirila Skufca Smrdel
  • Nikola Bešič
  • Vesna Homar


Background: Fatigue after breast cancer treatment is a major health problem that is difficult to treat. Our aim was to determine whether the early introduction of integrated rehabilitation from the beginning of the cancer treatment is associated with the frequency of fatigue in breast cancer patients.

Methods: The subjects of our prospective study were 600 female breast cancer patients (29–65 (mean 52 years) of age), who participated in the pilot study on the individualized integrated rehabilitation of breast cancer patients in 2019-2021 and were monitored for one year. The control group included 301 patients and the intervention group numbered 299 patients. The patients completed three questionnaires (EORTC QLQ-C30, -BR23 and NCCN): before cancer treatment, and then six and twelve months after the beginning of cancer treatment. The control group obtained the same rehabilitation offered in our regular program also before the presented study and the intervention group was part of the multidisciplinary and integrated approach of rehabilitation. Data on the patients’ demographics, disease extent, cancer treatment and complaints reported in questionnaires were collected and analyzed.

Results: There were no differences between the control and the intervention group of patients in terms of age, education, disease extent, surgical procedures, systemic cancer treatment, or radiotherapy, and also no differences in the fatigue before the beginning of treatment. However, patients from the control group had a greater level of constant fatigue than patients from the intervention group half a year (p=0.018) and a year (p=0.001) after the beginning of treatment. Furthermore, a greater proportion of patients from the control group experienced significant interference with their usual activities from fatigue than from the intervention group, half a year (p=0.042) and a year (p=0.001) after the treatment. A multivariate logistic regression showed that one year after the beginning of treatment, the only independent factor correlated to fatigue was inclusion into the intervention group (p=0.044). Inclusion in the intervention group was beneficial—patients from the control group were 1.5 times more likely to be fatigued.

Conclusion: Early integrated rehabilitation is associated with a lower prevalence of chronic fatigue or fatigue interfering with usual activities in breast cancer patients in comparison to the control group of patients.




How to Cite

Auprih, M., Zagar, T., Kovacevic, N., Skufca Smrdel, A. C. ., Bešič, N., & Homar, V. (2024). Impact of early integrated rehabilitation on fatigue in 600 patients with breast cancer - A prospective study. Radiology and Oncology, 58(2), 243–257. Retrieved from



Clinical oncology