title: Long-term chemotherapy-induced peripheral neuropathy among breast cancer survivors: prevalence, risk factors, and fall risk.
abstract: Chemotherapy-induced peripheral neuropathy (CIPN) is a common toxicity associated with chemotherapy, but researchers rarely study its risk factors, fall risk, and prevalence in long-term breast cancer survivors. We aimed to determine CIPN prevalence, risk factors, and association with psychological distress and falls among long-term breast cancer survivors. We conducted Cross-sectional analyses among postmenopausal women with a history of stage I-III breast cancer who received taxane-based chemotherapy. Participants reported neuropathic symptoms of tingling/numbness in hands and/or feet on a 0-10 numerical rating scale. We conducted multivariate logistic regression analyses to evaluate risk factors associated with the presence of CIPN and the relationship between CIPN and anxiety, depression, insomnia, and patient-reported falls. Among 296 participants, 173 (58.4 %) reported CIPN symptoms, 91 (30.7 %) rated their symptoms as mild, and 82 (27.7 %) rated them moderate to severe. Compared with women of normal weight, being obese was associated with increased risk of CIPN (adjusted OR 1.94, 95 % CI: 1.03-3.65). Patients with CIPN reported greater insomnia severity, anxiety, and depression than those without (all p < 0.05). Severity of CIPN was associated with higher rates of falls, with 23.8, 31.9, and 41.5 % in the "no CIPN," "mild," and "moderate-to-severe" groups, respectively, experiencing falls (p = 0.028). The majority of long-term breast cancer survivors who received taxane-based chemotherapy reported CIPN symptoms; obesity was a significant risk factor. Those with CIPN also reported increased psychological distress and falls. Interventions need to target CIPN and comorbid psychological symptoms, and incorporate fall prevention strategies for aging breast cancer survivors.
authors: Memorial Sloan Kettering Cancer Center, 1429 First Avenue, New York, NY, 10021, USA. baot@mskcc.org.
authors: Ting
authors: T
authors: Bao
authors: Memorial Sloan Kettering Cancer Center, 1429 First Avenue, New York, NY, 10021, USA.
authors: Coby
authors: C
authors: Basal
authors: Memorial Sloan Kettering Cancer Center, 1429 First Avenue, New York, NY, 10021, USA.
authors: Christina
authors: C
authors: Seluzicki
authors: Memorial Sloan Kettering Cancer Center, 1429 First Avenue, New York, NY, 10021, USA.
authors: Susan Q
authors: SQ
authors: Li
authors: Memorial Sloan Kettering Cancer Center, 300 66th Street, New York, NY, 10065, USA.
authors: Andrew D
authors: AD
authors: Seidman
authors: Memorial Sloan Kettering Cancer Center, 1429 First Avenue, New York, NY, 10021, USA.
authors: Jun J
authors: JJ
authors: Mao
mesh_terms: D000058:Accidental Falls; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000523:psychology; D000073116:Cancer Survivors / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced / Q000453:epidemiology* / Q000523:psychology; D017698:Postmenopause; D015995:Prevalence; D012307:Risk Factors; D043823:Taxoids / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D043823:Taxoids
keywords: Breast cancer; Chemotherapy; Falls; Obesity; Peripheral neuropathy