Prevalence, risk factors, and sequelae of long-term chemotherapy-induced peripheral neuropathy (CIPN) among breast cancer survivors.

e21599 Background: Peripheral neuropathy (PN) is a common complication from chemotherapy (CTX), associated with significant morbidity, and may improve with time. The prevalence of long-term PN symptoms in breast cancer survivors is not well known. We sought to explore PN symptoms and associated risk factors among breast cancer survivors at least 2 years out from diagnosis. Methods: We performed a cross-sectional retrospective study investigating the prevalence of patient-reported numbness/tingling symptoms as a surrogate for PN in breast cancer survivors at our institution. We included patients with stage 0-III breast cancer who completed a questionnaire about symptoms and life-style habits at a survivorship visit that occurred 2 or more years after initial diagnosis. We evaluated the prevalence of PN and associated risk factors using univariable and multivariable logistic regression analysis; results are shown as odds ratio (OR) and 95% confidence interval (CI). Results: 605 patients assessed between April 2009 and October 2016 met eligibility for analysis. Median age was 60 (31-93) years. Median number of years from diagnosis to assessment was 6.3 (2-21). All patients had surgery and 62% had CTX. Twenty-seven percent reported PN. On univariable analysis, obesity, stage II & III, mastectomy, PN before diagnosis, and receipt of taxane CTX were associated with PN (all p < 0.05). Patients who were older, exercised before diagnosis, had ER/PR-positive disease and who received endocrine therapy reported less PN (all p < 0.05). On multivariable analysis, only receipt of docetaxel (OR: 2.18, CI: 1.22- 3.88) or paclitaxel (OR: 4.07, CI: 2.54-6.50) and reporting PN symptoms before diagnosis (OR: 3.28, CI: 1.49-7.21) were associated with PN. Among patients without pre-existing PN symptoms, 15%, 19%, 28% and 43% reported long-term PN after no CTX, non-taxane CTX, docetaxel CTX and paclitaxel CTX respectively. Conclusions: At a median follow-up of 6.3 years from diagnosis, 28% of survivors in our cohort who had received docetaxel and 43% who had received paclitaxel report long-term PN symptoms compared with 15-19% in those who received no or non-taxane CTX. These data can help inform patients and clinicians regarding long-term PN risk following CTX.

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Long-term chemotherapy-induced peripheral neuropathy among breast cancer survivors: prevalence, risk factors, and fall risk

Breast Cancer Research and Treatment ◽

10.1007/s10549-016-3939-0 ◽

2016 ◽

Vol 159 (2) ◽

pp. 327-333 ◽

Cited By ~ 93

Author(s):

Ting Bao ◽

Coby Basal ◽

Christina Seluzicki ◽

Susan Q. Li ◽

Andrew D. Seidman ◽

...

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Peripheral Neuropathy ◽

Cancer Survivors ◽

Fall Risk ◽

Breast Cancer Survivors

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Assessment of Potential Risk Factors and Skin Ultrasound Presentation Associated with Breast Cancer-Related Lymphedema in Long-Term Breast Cancer Survivors

Diagnostics ◽

10.3390/diagnostics11081303 ◽

2021 ◽

Vol 11 (8) ◽

pp. 1303

Author(s):

Khairunnisa’ Md Yusof ◽

Kelly A. Avery-Kiejda ◽

Shafinah Ahmad Suhaimi ◽

Najwa Ahmad Zamri ◽

Muhammad Ehsan Fitri Rusli ◽

...

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Cancer Survivors ◽

Potential Risk ◽

Breast Cancer Survivors ◽

Ultrasound Examination ◽

Arm Circumference ◽

Potential Risk Factors ◽

Breast Cancer Related Lymphedema

Breast cancer has been reported to have the highest survival rate among various cancers. However, breast cancer survivors face several challenges following breast cancer treatment including breast cancer-related lymphedema (BCRL), sexual dysfunction, and psychological distress. This study aimed to investigate the potential risk factors of BCRL in long term breast cancer survivors. A total of 160 female breast cancer subjects were recruited on a voluntary basis and arm lymphedema was assessed through self-reporting of diagnosis, arm circumference measurement, and ultrasound examination. A total of 33/160 or 20.5% of the women developed BCRL with significantly higher scores for upper extremity disability (37.14 ± 18.90 vs. 20.08 ± 15.29, p < 0.001) and a lower score for quality of life (103.91 ± 21.80 vs. 115.49 ± 16.80, p = 0.009) as compared to non-lymphedema cases. Univariate analysis revealed that multiple surgeries (OR = 5.70, 95% CI: 1.21–26.8, p < 0.001), axillary lymph nodes excision (>10) (OR = 2.83, 95% CI: 0.94–8.11, p = 0.047), being overweight (≥25 kg/m2) (OR = 2.57, 95% CI: 1.04 – 6.38, p = 0.036), received fewer post-surgery rehabilitation treatment (OR = 2.37, 95% CI: 1.05–5.39, p = 0.036) and hypertension (OR = 2.38, 95% CI: 1.01–5.62, p = 0.043) were associated with an increased risk of BCRL. Meanwhile, multivariate analysis showed that multiple surgeries remained significant and elevated the likelihood of BCRL (OR = 5.83, 95% CI: 1.14–29.78, p = 0.034). Arm swelling was more prominent in the forearm area demonstrated by the highest difference of arm circumference measurement when compared to the upper arm (2.07 ± 2.48 vs. 1.34 ± 1.91 cm, p < 0.001). The total of skinfold thickness of the affected forearm was also significantly higher than the unaffected arms (p < 0.05) as evidenced by the ultrasound examination. The continuous search for risk factors in specific populations may facilitate the development of a standardized method to reduce the occurrence of BCRL and provide better management for breast cancer patients.

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Treatment-related risk factors for arm lymphedema among long-term breast cancer survivors

Journal of Cancer Survivorship ◽

10.1007/s11764-014-0416-9 ◽

2015 ◽

Vol 9 (3) ◽

pp. 422-430 ◽

Cited By ~ 11

Author(s):

Nandita Das ◽

Richard N. Baumgartner ◽

Elizabeth C. Riley ◽

Christina M. Pinkston ◽

Dongyan Yang ◽

...

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Related Risk ◽

Arm Lymphedema

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Asymptomatic cardiotoxicity in long-term breast cancer survivors.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e24084 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e24084-e24084

Author(s):

Mohammed Alaeddine Saidi ◽

Soumeyya Ghomari

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Cancer Survivors ◽

Endocrine Therapy ◽

Early Breast Cancer ◽

Breast Cancer Survivors ◽

Left Ventricular ◽

Left Ventricular Ejection

e24084 Background: Multimodal approach in the adjuvant treatment of early breast cancer has led to a significant number of survivors. However, the combination of these treatments may increase the risk of long-term cardiotoxicity, particularly in the presence of cardiovascular risk factors (CVRF). Methods: We examined cardiac function in patients who had previously been treated for early breast cancer. Echocardiograms were performed at least 2 years after therapy. We measured left ventricular ejection fraction (LVEF) and reported pre-treatment LVEF and all CVRF. The initial Framingham Risk Score (FRS) has been calculated. Asymptomatic cardiotoxicity was defined by decrease of 5% or more in the LVEF value without clinical symptoms of CHF. Doxorubicin, Trastuzumab, Radiotherapy, older age, and CVRF (hypertension (HTN), diabetes, dyslipidemia, obesity, Waist circumference) were evaluated as potential risk factors for the development of cardiotoxicity. All statistical analysis was performed using SPSS version 25.0. Results: A total of 143 breast cancer survivors with a median age of 46 ± 10 years (range: 26-72) underwent Echocardiogram imaging after a median follow-up of 9,22 years (range: 2 - 22). 48 women were postmenopausal at diagnostic. 32,2% were obese. HTN was present in 15%, diabetes in 12%, and dyslipidemia in 12% of patients. ARA-II was the most used treatment of HTN (55%). 11,9% of patients were under statin therapy. FRS was low in 69%, moderate in 22% and high in 9% of patients. 4 patients had received endocrine therapy alone, none of whom developed cardiotoxicity. There was only one case of symptomatic cardiotoxicity. In the remaining 138 women who received multimodal treatment (Anthracyclines:100%, Docetaxel:62,9%, Endocrine therapy:72%, Trastuzumab:7%, Radiotherapy:83,2%), a statistical but non-clinically significant decrease was observed in LVEF (67.7 ± 3.6 to 65.4 ± 5.1, p < 0.001). 39 women (28,3%) developed asymptomatic cardiotoxicity. In multivariate analysis, factors that contributed to decreased LVEF were HTN (p = 0,006), diabetes (p = 0,008) and dyslipidemia (p = 0,03). Conclusions: The use of adjuvant therapy in breast cancer may increase long term cardiotoxicity particularly in survivors with CVRF. Long-term cardiac follow-up is essential in order to initiate cardioprotective therapy at the right time.

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Evaluating the prevalence of cardiovascular risk factors among breast cancer survivors and the outcomes of cardio-oncology referrals by a breast cancer survivorship clinic.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.26_suppl.107 ◽

2013 ◽

Vol 31 (26_suppl) ◽

pp. 107-107

Author(s):

Jennifer R. Klemp ◽

Lori Ranallo ◽

Catie Knight ◽

Carol J. Fabian ◽

Christie A. Befort

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Cardiovascular Risk ◽

Cancer Survivors ◽

Cardiovascular Risk Factors ◽

Cancer Survivorship ◽

Breast Cancer Survivors ◽

Breast Cancer Survivorship ◽

Term Care

107 Background: Breast cancer survivors have a 4x increased incidence of cardiovascular disease (CVD) compared to women never treated for breast cancer and cardiac events are the 2nd most common cause of death in long-term survivors. Attention to reducing the risk of CVD should be a priority for the long-term care of breast cancer survivors. This study was undertaken to describe cardiovascular risk factors in breast cancer survivors, and the cardio-oncology referral patterns and outcomes from cardio-oncology screening visits. Methods: 356 female breast cancer survivors seen at the University of Kansas Breast Cancer Survivorship Center between 2006 and 2012 who completed an initial intake visit were evaluated for cardiovascular risk factors and referrals to cardio-oncology. An expanded list of cardiovascular factors was used: BMI > 25, Diabetes, HTN, HLD, Current/Past Smoker, Family Hx of MI < 60 years, Exercise < 150 min/wk, Ejection Fraction < 50%, and exposure to cardio-toxic breast cancer treatment. Breast cancer survivors without evidence of metastatic disease were on average 57.8 +/-11.0 years old, underwent standard treatment regimens, and were approximately 7.5 years from their initial diagnosis. Results: 13% were already followed by a cardiologist, 21% were referred to cardio-oncology, and 66% were not referred at their initial survivorship visit. There were significant differences in the average number of risk factors between those not referred to cardio-oncology (4.36 +/-1.89), and those referred to cardio-oncology (5.68+/-1.8), and between those already followed by cardiologist (5.91+/-1.75), p < 0.001 and p < 0.0001, respectively. The most common risk factors were BMI >25, elevated HDL, exercise <150 min/wk, and exposure to an anthracycline. The most common outcomes following a cardio-oncology visit included further diagnostic tests, medication changes, or a return visit. Conclusions: These findings demonstrate the need to determine how to include treatment related risk factors along with traditional cardiovascular risk factors in assessing and managing cardiovascular risk in breast cancer survivors.

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Long-term peripheral neuropathy symptoms in breast cancer survivors

Breast Cancer Research and Treatment ◽

10.1007/s10549-017-4437-8 ◽

2017 ◽

Vol 166 (2) ◽

pp. 519-526 ◽

Cited By ~ 17

Author(s):

Moaath Mustafa Ali ◽

Machelle Moeller ◽

Lisa Rybicki ◽

Halle C. F. Moore

Keyword(s):

Breast Cancer ◽

Peripheral Neuropathy ◽

Cancer Survivors ◽

Breast Cancer Survivors

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Behavioral risk factors and their relationship to tumor characteristics in Hispanic and non-Hispanic white long-term breast cancer survivors

Breast Cancer Research and Treatment ◽

10.1007/s10549-011-1705-x ◽

2011 ◽

Vol 131 (1) ◽

pp. 169-176 ◽

Cited By ~ 16

Author(s):

Madiha F. Abdel-Maksoud ◽

Betsy C. Risendal ◽

Marty L. Slattery ◽

Anna R. Giuliano ◽

Kathy B. Baumgartner ◽

...

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Behavioral Risk Factors ◽

Behavioral Risk ◽

Tumor Characteristics ◽

Hispanic White

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Depression als Begleiterkrankung – auch noch Jahre nach der Therapie

Deutsche Zeitschrift für Onkologie ◽

10.1055/a-1379-4898 ◽

2021 ◽

Vol 53 (01) ◽

pp. 22-26

Keyword(s):

Breast Cancer ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Female Population ◽

Population Controls

Doege D, Thong MS, Koch-Gallenkamp L et al.Age-specific prevalence and determinants of depression in long-term breast cancer survivors compared to female population controls. Cancer Med 2020; 9: 8713–8721. doi:10.1002/cam4.3476

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