SpringerLink
Log in

Long-term peripheral neuropathy symptoms in breast cancer survivors

  • Clinical trial
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Purpose

Peripheral neuropathy (PN) is a common and distressing complication from chemotherapy. Symptoms often, but not always, 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, and anesthesia symptoms as a surrogate for PN in breast cancer survivors. We included patients with stage 0–III breast cancer who completed a clinical questionnaire at a survivorship visit that occurred 2 or more years after diagnosis. We estimated the prevalence of PN and identified risk factors for PN.

Results

Six hundred and five patients assessed between April 2009 and October 2016 met eligibility for analysis. Median age was 60 years. Median number of years from diagnosis to assessment was 6.3. All patients had surgery and 62% had chemotherapy. Twenty-seven percent reported PN. On univariable analysis, obesity, stage II and III, mastectomy, PN before diagnosis, and receipt of taxane chemotherapy were associated with higher risk of PN (all p < 0.05); older age, exercise, ER-positive disease, and endocrine therapy were associated with lower risk of 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 higher risk of PN. Overall, 17, 20, 31, and 44% reported long-term PN symptoms after no chemotherapy, non-taxane chemotherapy, docetaxel chemotherapy, and paclitaxel chemotherapy, respectively.

Conclusion

Long-term peripheral neuropathy symptoms are reported by a significant minority of breast cancer survivors, particularly following paclitaxel or docetaxel chemotherapy. These study findings can help inform patients and clinicians regarding long-term PN risk following chemotherapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Cavaletti G, Zanna C (2002) Current status and future prospects for the treatment of chemotherapy-induced peripheral neurotoxicity. Eur J Cancer 38(14):1832–1837

    Article  CAS  PubMed  Google Scholar 

  2. Balayssac D, Ferrier J, Descoeur J, Ling B, Pezet D, Eschalier A, Authier N (2011) Chemotherapy-induced peripheral neuropathies: from clinical relevance to preclinical evidence. Expert Opin Drug Saf 10(3):407–417

    Article  CAS  PubMed  Google Scholar 

  3. England JD, Gronseth GS, Franklin G, Miller RG, Asbury AK, Carter GT, Cohen JA, Fisher MA, Howard JF, Kinsella LJ, Latov N, Lewis RA, Low PA, Sumner AJ (2005) Distal symmetric polyneuropathy: a definition for clinical research: report of the American Academy of Neurology, the American Association of Electrodiagnostic Medicine, and the American Academy of Physical Medicine and Rehabilitation. Neurology 64(2):199–207. doi:10.1212/01.wnl.0000149522.32823.ea

    Article  CAS  PubMed  Google Scholar 

  4. Cavaletti G, Marmiroli P (2015) Chemotherapy-induced peripheral neurotoxicity. Curr Opin Neurol 28(5):500–507

    Article  CAS  PubMed  Google Scholar 

  5. Pachman DR, Barton DL, Swetz KM, Loprinzi CL (2012) Troublesome symptoms in cancer survivors: fatigue, insomnia, neuropathy, and pain. J Clin Oncol 30(30):3687–3696. doi:10.1200/jco.2012.41.7238

    Article  PubMed  Google Scholar 

  6. Mols F, Beijers T, Vreugdenhil G, van de Poll-Franse L (2014) Chemotherapy-induced peripheral neuropathy and its association with quality of life: a systematic review. Support Care Cancer 22(8):2261–2269

    Article  PubMed  Google Scholar 

  7. Pike CT, Birnbaum HG, Muehlenbein CE, Pohl GM, Natale RB (2012) Healthcare costs and workloss burden of patients with chemotherapy-associated peripheral neuropathy in breast, ovarian, head and neck, and nonsmall cell lung cancer. Chemother Res Pract 2012:913848. doi:10.1155/2012/913848

    PubMed  PubMed Central  Google Scholar 

  8. Jud SM, Hatko R, Maihofner C, Bani MR, Schrauder MG, Lux MP, Beckmann MW, Bani G, Eder I, Fasching PA, Loehberg CR, Rauh C, Hein A (2014) Comprehensive visualization of paresthesia in breast cancer survivors. Arch Gynecol Obstet 290(1):135–141. doi:10.1007/s00404-014-3164-1

    Article  PubMed  Google Scholar 

  9. Hershman DL, Weimer LH, Wang A, Kranwinkel G, Brafman L, Fuentes D, Awad D, Crew KD (2011) Association between patient reported outcomes and quantitative sensory tests for measuring long-term neurotoxicity in breast cancer survivors treated with adjuvant paclitaxel chemotherapy. Breast Cancer Res Treat 125(3):767–774. doi:10.1007/s10549-010-1278-0

    Article  CAS  PubMed  Google Scholar 

  10. Tanabe Y, Hashimoto K, Shimizu C, Hirakawa A, Harano K, Yunokawa M, Yonemori K, Katsumata N, Tamura K, Ando M, Kinoshita T, Fujiwara Y (2013) Paclitaxel-induced peripheral neuropathy in patients receiving adjuvant chemotherapy for breast cancer. Int J Clin Oncol 18(1):132–138. doi:10.1007/s10147-011-0352-x

    Article  CAS  PubMed  Google Scholar 

  11. Mustafa Ali M, Moeller M, Rybicki L, Moore HC (2017) Prevalence and correlates of patient-reported symptoms and comorbidities in breast cancer survivors at a tertiary center. J Cancer Survivorship. doi:10.1007/s11764-017-0612-5

    Google Scholar 

  12. Bao T, Basal C, Seluzicki C, Li SQ, Seidman AD, Mao JJ (2016) Long-term chemotherapy-induced peripheral neuropathy among breast cancer survivors: prevalence, risk factors, and fall risk. Breast Cancer Res Treat 159(2):327–333. doi:10.1007/s10549-016-3939-0

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG (2009) Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 42(2):377–381

    Article  PubMed  Google Scholar 

  14. Mayer DK, Nekhlyudov L, Snyder CF, Merrill JK, Wollins DS, Shulman LN (2014) American Society of Clinical Oncology clinical expert statement on cancer survivorship care planning. J Oncol Pract Am Soc Clin Oncol 10(6):345–351. doi:10.1200/jop.2014.001321

    Article  Google Scholar 

  15. Hausman J, Ganz PA, Sellers TP, Rosenquist J (2011) Journey forward: the new face of cancer survivorship care. J Oncol Pract Am Soc Clin Oncol 7(3 Suppl):e50s–56s. doi:10.1200/jop.2011.000306

    Article  Google Scholar 

  16. Andersen KG, Jensen MB, Kehlet H, Gartner R, Eckhoff L, Kroman N (2012) Persistent pain, sensory disturbances and functional impairment after adjuvant chemotherapy for breast cancer: cyclophosphamide, epirubicin and fluorouracil compared with docetaxel+epirubicin and cyclophosphamide. Acta Oncol 51(8):1036–1044. doi:10.3109/0284186x.2012.692884

    Article  CAS  PubMed  Google Scholar 

  17. Eckhoff L, Knoop A, Jensen MB, Ewertz M (2015) Persistence of docetaxel-induced neuropathy and impact on quality of life among breast cancer survivors. Eur J Cancer 51(3):292–300. doi:10.1016/j.ejca.2014.11.024

    Article  CAS  PubMed  Google Scholar 

  18. Seretny M, Currie GL, Sena ES, Ramnarine S, Grant R, MacLeod MR, Colvin LA, Fallon M (2014) Incidence, prevalence, and predictors of chemotherapy-induced peripheral neuropathy: a systematic review and meta-analysis. Pain 155(12):2461–2470. doi:10.1016/j.pain.2014.09.020

    Article  PubMed  Google Scholar 

  19. Osmani K, Vignes S, Aissi M, Wade F, Milani P, Levy BI, Kubis N (2012) Taxane-induced peripheral neuropathy has good long-term prognosis: a 1- to 13-year evaluation. J Neurol 259(9):1936–1943. doi:10.1007/s00415-012-6442-5

    Article  PubMed  Google Scholar 

  20. Kerckhove N, Collin A, Condé S, Chaleteix C, Pezet D, Balayssac D (2017) Long-term effects, pathophysiological mechanisms, and risk factors of chemotherapy-induced peripheral neuropathies: a comprehensive literature review. Front Pharmacol. doi:10.3389/fphar.2017.00086

    PubMed  PubMed Central  Google Scholar 

  21. Alberti P, Rossi E, Cornblath DR, Merkies IS, Postma TJ, Frigeni B, Bruna J, Velasco R, Argyriou AA, Kalofonos HP, Psimaras D, Ricard D, Pace A, Galie E, Briani C, Dalla Torre C, Faber CG, Lalisang RI, Boogerd W, Brandsma D, Koeppen S, Hense J, Storey D, Kerrigan S, Schenone A, Fabbri S, Valsecchi MG, Cavaletti G (2014) Physician-assessed and patient-reported outcome measures in chemotherapy-induced sensory peripheral neurotoxicity: two sides of the same coin. Ann Oncol 25(1):257–264

    Article  CAS  PubMed  Google Scholar 

Download references

Funding

No funding received for this research.

Author information

Authors and Affiliations

  1. Internal Medicine, Cleveland Clinic, Cleveland, OH, USA

    Moaath Mustafa Ali

  2. Solid Tumor Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland Clinic, 10201 Carnegie Ave, CA-60, Cleveland, OH, 44195, USA

    Machelle Moeller & Halle C. F. Moore

  3. Quantitative Health Sciences, Cleveland Clinic Lerner Research Institute, Cleveland, OH, USA

    Lisa Rybicki

Authors
  1. Moaath Mustafa Ali
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Machelle Moeller
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lisa Rybicki
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Halle C. F. Moore
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Halle C. F. Moore.

Ethics declarations

Conflict of interest

Authors declare that there is no conflict of interest.

Ethical approval

All procedures performed in studies were in accordance with the ethical standards of the Cleveland Clinic institutional review board and the national research committee and with the 1964 Helsinki declaration and its later amendments.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Previous presentation

Study results were published online for 2017 ASCO Annual Meeting.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mustafa Ali, M., Moeller, M., Rybicki, L. et al. Long-term peripheral neuropathy symptoms in breast cancer survivors. Breast Cancer Res Treat 166, 519–526 (2017). https://doi.org/10.1007/s10549-017-4437-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10549-017-4437-8

Keywords

Search

Navigation