Long term peripheral neuropathy symptoms in breast cancer survivors.

Abstract

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.