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Fatigue and sleep quality, rather than pain severity, are central in the symptom network of breast cancer survivors with pain, with fatigue linking sleep problems to perceived injustice.

In a cross-sectional network analysis of 278 breast cancer survivors with pain, fatigue and sleep-related symptoms occupied central positions in the symptom network, while pain severity showed no directionality. Fatigue appeared to be a key linking mechanism between perceived injustice and sleep, and pain catastrophizing was primarily associated with perceived injustice unfairness.

Last updated: Aug 14, 2026•0 RCTs•📖 Read as article →

Evidence Score

Evidence Score32/100
Human RCT☆☆☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. The role of fatigue and sleep quality in the link between pain severity, perceived injustice and pain catastrophizing in breast cancer survivors with pain: a network analysis.

observational

Roose E, Goossens Z, Ubaghs S, Mairesse O, van Wilgen P, Smeets L, Nijs J, Huysmans E, Lahousse A · Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer (2026)

Participants: N/A
Duration: N/A
Intervention: None (observational network analysis)
Outcome: Network centrality and directional dependencies among pain severity, pain catastrophizing, perceived injustice, fatigue, and sleep quality
Effect Size: N/A
Population: 278 breast cancer survivors with pain (baseline data from two RCTs)

Result:

PubMed: 42576023DOI: 10.1007/s00520-026-11068-0

Mechanism Graph

Fatigue and sleep-related symptoms are central nodes in the symptom network
↓
Fatigue links sleep problems to perceived injustice
↓
Pain catastrophizing is primarily associated with perceived injustice unfairness
↓
Pain severity shows no directionality within the network

Limitations

  • ⚠Cross-sectional design prevents causal inference
  • ⚠Secondary analysis of baseline data from RCTs may limit generalizability

Frequently Asked Questions

What is the main finding of this study?▼

Fatigue and sleep quality are central in the symptom network of breast cancer survivors with pain, and fatigue links sleep problems to perceived injustice.

What was the sample size?▼

278 breast cancer survivors with pain.

What statistical methods were used?▼

Regularized Gaussian Graphical Model (GGM) for partial correlations and Directed Acyclic Graph (DAG) for directional probabilities.

What are the clinical implications?▼

Perceived injustice may be a key target for interventions, beyond pain severity, in breast cancer survivors with pain.

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References

  1. 1.Roose E, Goossens Z, Ubaghs S, Mairesse O, van Wilgen P, Smeets L, Nijs J, Huysmans E, Lahousse A. "The role of fatigue and sleep quality in the link between pain severity, perceived injustice and pain catastrophizing in breast cancer survivors with pain: a network analysis.." Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2026. PMID: 42576023 DOI: 10.1007/s00520-026-11068-0
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.