Date of Award


Degree Type


Degree Name

PhD Health Sciences


Health and Medical Sciences


Dr. Genevieve Pinto-Zipp

Committee Member

Dr. David Felten

Committee Member

Dr. Terrence F. Cahill


Cancer, Breast cancer, Cancer related fatigue, Upper extremity function, Cancer survivors


Background: Cancer-related fatigue (CRF) and arm morbidity constitute the two most common symptom complexes impacting breast cancer survivors (BCS) following surgery and adjuvant treatment, but these multifaceted entities have traditionally been researched as if they were separately occurring events in the survivor’s recovery. Objective: This study examined the relationship between breast cancer survivors’ perceptions of CRF and upper extremity function one to six years post-diagnosis. The study further investigated the impact of multiple adjuvant therapies, node dissection procedures, caring for dependent children, and physical aspects of employment on CRF and upper extremity function. Methods: One hundred fifty-eight BCS responded to an exploratory internet-based cross-sectional demographic survey, the FACIT-F and the DASH. Descriptive statistics, correlation and simple linear regression were used for data analysis. Results: An analysis revealed a moderate statistically significant relationship between CRF and upper extremity function, r = -.661, p < .001, such that BCS with higher levels of fatigue also exhibited higher levels of arm morbidity. In addition, 22.3% reported persistent fatigue symptoms, consistent with the criteria for a diagnosis of CRF, with 45.5% of the fatigued subset also reporting significant limitations in upper body function. BCS demonstrated significantly higher levels of fatigue when compared to prior research on a nationally representative sample of adults (p = .037). Women who were caregivers of at least one dependent child demonstrated higher levels of fatigue than women without dependent children (p = 0.38). The BCS reported high levels of function overall indicating that many survivors are functioning well in the years that follow treatment, however a subset of women reported persistent problems that interfere with daily function and participation, and the overall sample was more fatigued than the general population. Conclusions: The results from this exploratory study document preliminary evidence that a relationship exists between CRF and upper extremity morbidity. It also adds support for persistent fatigue in a subset of BCS long after surgery and adjuvant therapies conclude. Further research is indicated in order to meet the long term survivorship needs of this growing population.

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Oncology Commons