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

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.15_suppl.e21661 ◽

2016 ◽

Vol 34 (15_suppl) ◽

pp. e21661-e21661 ◽

Cited By ~ 1

Author(s):

Ting Bao ◽

Susan Q Li ◽

Jun J. Mao

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Peripheral Neuropathy ◽

Cancer Survivors ◽

Breast Cancer Survivors

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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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Patient-reported pain and other symptoms among breast cancer survivors: prevalence and risk factors

Tumori Journal ◽

10.1177/0300891620908930 ◽

2020 ◽

Vol 106 (6) ◽

pp. 480-490

Author(s):

Michele Divella ◽

Luigi Vetrugno ◽

Serena Bertozzi ◽

Luca Seriau ◽

Carla Cedolini ◽

...

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Chronic Pain ◽

Neuropathic Pain ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Breast Tissue ◽

Shoulder Function ◽

Breast Cancer Surgery ◽

Patient Reported

Objective: To investigate the prevalence and risk factors associated with chronic pain and other symptoms related to breast cancer 6 months after surgery. Methods: In an observational study of 261 female breast cancer survivors treated between January 2017 and January 2018, patients were asked about their pain symptoms using a questionnaire that utilized the Numeric Rating Score (NRS) and the Douleur Neuropathique Score (DN4) for neuropathic pain; it also addressed phantom sensations and functional disorders on the ipsilateral shoulder. A total of 218 women completed the survey. Results: A total of 105 patients (48.17%) reported chronic pain. Of these, 64% rated the pain with an NRS of 1–3 and 35% with an NRS >3. Neuropathic pain was reported in 65% of the sample, phantom sensations in 12%, disorders of shoulder function in 16%, and web syndrome in 2%. Multivariable analyses showed that chronic pain (odds ratio [OR], 2.55; 95% confidence interval [CI], 1.094–5.942; p < 0.05) and neuropathic pain (OR, 2.988; 95% CI, 1.366–6.537; p < 0.05) were positively associated with surgical adverse events; phantom sensations were statistically associated with the weight of removed breast tissue (OR, 1.003; 95% CI, 1.001–1.005; p < 0.05). Conclusions: Our study highlights the need to employ specific tools capable of detecting different kinds of chronic pain after breast cancer surgery to improve pain prevention and treatment. Surgical complications and the weight of removed breast tissue emerged as 2 of the risk factors for chronic and neuropathic pain development in breast cancer survivors.

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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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