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Background There is some debate in the literature as to whether fatigue persists in the long term in women who have completed adjuvant breast cancer treatment. Methods A systematic review was conducted in order to characterise and quantify the phenomenon of post treatment fatigue (PTF). Results There was a wide variation in the measures of fatigue used, duration of follow-up and type of comparison made. Overall 18 studies were identified with a follow-up period of between 4 months and 10 years. Fourteen studies demonstrated the presence of continued PTF and/or differences in fatigue levels compared to a reference population up to 5 years after treatment. One short-term study reported no increase in fatigue at 4 months. Three studies (with an average follow up period of longer than 5 years) did not identify overall quality of life differences in breast cancer survivors when compared …