This narrative review synthesizes current evidence on breast cancer-related fatigue (BCRF), covering its mechanisms (inflammation, HPA axis dysregulation, mitochondrial dysfunction, neuromuscular impairment, psychosocial factors), biomarkers, risk factors, and intervention strategies in patients during and after breast cancer treatment.
Multiple intervention categories — including acupuncture, exercise, psychotherapy, pharmacotherapy, nutritional support, and microbiota modulation — show varying degrees of efficacy for BCRF; no single strategy is universally superior. Biomarkers such as cytokines, cortisol, leptin, and mitochondrial DNA show diagnostic and prognostic potential.
As a narrative review, it does not perform a systematic search or meta-analysis, limiting quantitative conclusions. No head-to-head comparison of intervention efficacy with pooled effect sizes is provided. Generalizability may be constrained by the heterogeneity of included studies.
Clinicians should consider BCRF a multimechanistic syndrome and tailor interventions — particularly exercise and psychotherapy — to individual patient risk profiles. Emerging biomarkers (cytokines, cortisol, mitochondrial DNA) may eventually guide more personalized management, but are not yet standard of care.
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