The prevalence of persistent peripheral neuropathy (PN) in early-stage breast cancer (ESBC) survivors is largely unknown. We explored the occurrence and risk factors of PN among long-term ESBC survivors treated with taxane chemotherapy.
A population-based cohort of 884 recurrence-free ESBC survivors diagnosed 2010–2015 in the South East Health Care region, Sweden and 1768 control women without prior cancer received a postal questionnaire that included the European Organisation for Research and Treatment of Cancer chemotherapy-induced peripheral neuropathy (CIPN20) items. Prevalence, relative risks (RRs) (Poisson regression) and risk factors (binomial regression) were calculated. Adjustments were made for confounding factors (e.g. age, body mass index, comorbidities).
The response rate was 79% for survivors and 59% for controls. The median time post taxane was 3.6 years (1.5–7.3 years). The adjusted RR was highest (RR 1.8) for “tingling/numbness of toes/feet”. Individual sensory symptoms occurred in 8.9–48.4% and motor symptoms in 7.2–61.3% of survivors; the most prevalent symptoms were “difficulty opening jar” and “cramps in feet”. Paclitaxel, older age, overweight, diabetes mellitus, vibrating hand tools, autoimmune disease and smoking were independent risk factors.
PN was more common among ESBC survivors than control women and many symptoms persisted over time. Risk factors should be considered when treatment decisions are made.
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We wish to thank all the study participants, Marika Wenemark for assistance in developing the questionnaire and Rasmus Mikiver for cancer register assistance.
Ethics approval and consent to participate
The Regional Ethics Committee in Linköping approved the study (Ref. no. 2016/548-31). All women who participated in the study gave informed consent by returning the questionnaire. The study was performed in accordance with the Declaration of Helsinki.
Consent to publish
This study contained no individual person’s data.
The dataset analysed during the current study is available from the corresponding author on reasonable request.
The funding sources played no role in the study. The authors declare no competing interests.
This work was supported by the Swedish Cancer Society (190224); the Medical Research Council of Southeast Sweden (FORSS-932359); Futurum—The Academy for Health and Care, Jönköping County Council (575361); Forsknings-ALF (LIO-901261).
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Engvall, K., Gréen, H., Fredriksson, M. et al. Persistent neuropathy among early-stage breast cancer survivors in a population-based cohort. Br J Cancer (2021). https://doi.org/10.1038/s41416-021-01429-3