Patient-reported persistent lymphedema and peripheral neuropathy among long-term breast cancer survivors in the Carolina Breast Cancer Study

IF 5.1 2区医学 Q1 ONCOLOGY Cancer Pub Date : 2024-11-17 DOI:10.1002/cncr.35650

Rina A. Yarosh PhD, MPH, Hazel B. Nichols PhD, Qichen Wang MS, Rachel Hirschey PhD, RN, Erin E. Kent PhD, Lisa A. Carey MD, Sandra C. Hayes PhD, Adeyemi A. Ogunleye MD, SM, Melissa A. Troester PhD, Eboneé N. Butler PhD

{"title":"Patient-reported persistent lymphedema and peripheral neuropathy among long-term breast cancer survivors in the Carolina Breast Cancer Study","authors":"Rina A. Yarosh PhD, MPH, Hazel B. Nichols PhD, Qichen Wang MS, Rachel Hirschey PhD, RN, Erin E. Kent PhD, Lisa A. Carey MD, Sandra C. Hayes PhD, Adeyemi A. Ogunleye MD, SM, Melissa A. Troester PhD, Eboneé N. Butler PhD","doi":"10.1002/cncr.35650","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Improved breast cancer treatment has lengthened survival but also has long-term impacts. Lymphedema and peripheral neuropathy are treatment-related sequelae that extend into survivorship. Co-occurrence of these conditions may further impair functional well-being. Few studies have estimated the burden of these conditions among diverse survivors.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Carolina Breast Cancer Study Phase 3 enrolled survivors diagnosed between 2008 and 2013 in North Carolina. Black and younger women (aged <50 years at diagnosis) were oversampled. With the use of ≥10 years of follow-up data, the prevalence of persistent lymphedema, peripheral neuropathy, and their co-occurrence was assessed. Prevalence differences (PDs) and 95% confidence intervals (CIs) were assessed according to patient and disease characteristics.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 1688 survivors were included, with an average of 11.1 years (SD, 0.6) postdiagnosis. The prevalence of persistent lymphedema, peripheral neuropathy, and their co-occurrence was 18.7%, 27.7%, and 8.8%, respectively. Lymphedema was higher among those receiving a mastectomy and with >5 lymph nodes removed, and peripheral neuropathy was higher among women treated with taxane-based chemotherapy. Co-occurrence was higher among women with >5 lymph nodes removed (vs. <5; PD, 5.4; 95% CI, 2.1 to 8.8) and those treated with taxane-based chemotherapy (vs. no chemotherapy; PD, 6.8; 95% CI, 3.9 to 9.7). The burden of lymphedema (PD, 2.7; 95% CI, 0.9 to 6.3) and peripheral neuropathy (PD, 5.8; 95% CI, 1.7 to 9.9) was higher among Black than White women. The prevalence of lymphedema (PD, 1.8; 95% CI, −1.5 to 5.1) and peripheral neuropathy (PD, 4.6; 95% CI, 0.8 to 8.4) was elevated among younger compared to older women.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Lymphedema and peripheral neuropathy affect a substantial proportion of survivors. Interventions are needed to reduce this burden.</p>\n </section>\n </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 1","pages":""},"PeriodicalIF":5.1000,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cancer","FirstCategoryId":"3","ListUrlMain":"https://acsjournals.onlinelibrary.wiley.com/doi/10.1002/cncr.35650","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Improved breast cancer treatment has lengthened survival but also has long-term impacts. Lymphedema and peripheral neuropathy are treatment-related sequelae that extend into survivorship. Co-occurrence of these conditions may further impair functional well-being. Few studies have estimated the burden of these conditions among diverse survivors.

Methods

Carolina Breast Cancer Study Phase 3 enrolled survivors diagnosed between 2008 and 2013 in North Carolina. Black and younger women (aged <50 years at diagnosis) were oversampled. With the use of ≥10 years of follow-up data, the prevalence of persistent lymphedema, peripheral neuropathy, and their co-occurrence was assessed. Prevalence differences (PDs) and 95% confidence intervals (CIs) were assessed according to patient and disease characteristics.

Results

A total of 1688 survivors were included, with an average of 11.1 years (SD, 0.6) postdiagnosis. The prevalence of persistent lymphedema, peripheral neuropathy, and their co-occurrence was 18.7%, 27.7%, and 8.8%, respectively. Lymphedema was higher among those receiving a mastectomy and with >5 lymph nodes removed, and peripheral neuropathy was higher among women treated with taxane-based chemotherapy. Co-occurrence was higher among women with >5 lymph nodes removed (vs. <5; PD, 5.4; 95% CI, 2.1 to 8.8) and those treated with taxane-based chemotherapy (vs. no chemotherapy; PD, 6.8; 95% CI, 3.9 to 9.7). The burden of lymphedema (PD, 2.7; 95% CI, 0.9 to 6.3) and peripheral neuropathy (PD, 5.8; 95% CI, 1.7 to 9.9) was higher among Black than White women. The prevalence of lymphedema (PD, 1.8; 95% CI, −1.5 to 5.1) and peripheral neuropathy (PD, 4.6; 95% CI, 0.8 to 8.4) was elevated among younger compared to older women.

Conclusions

Lymphedema and peripheral neuropathy affect a substantial proportion of survivors. Interventions are needed to reduce this burden.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

卡罗莱纳乳腺癌研究》中长期乳腺癌幸存者的持续性淋巴水肿和周围神经病变的患者报告。

背景：乳腺癌治疗方法的改进延长了患者的生存期，但也带来了长期影响。淋巴水肿和周围神经病变是与治疗相关的后遗症，会延续到生存期。同时出现这些症状可能会进一步损害患者的功能。很少有研究对不同幸存者的这些疾病负担进行估算：卡罗莱纳州乳腺癌研究第三阶段招募了 2008 年至 2013 年期间在北卡罗来纳州确诊的幸存者。结果：共有 1688 名幸存者参加了该研究：共纳入了 1688 名幸存者，她们在确诊后平均生活了 11.1 年（SD，0.6）。持续性淋巴水肿、周围神经病变及其并发症的发病率分别为 18.7%、27.7% 和 8.8%。淋巴水肿在接受乳房切除术且切除淋巴结>5个的妇女中发病率较高，而周围神经病变在接受以类固醇为基础的化疗的妇女中发病率较高。在淋巴结被切除多于5个的女性中，同时发生淋巴水肿和周围神经病变的比例更高（与切除多于5个淋巴结的女性相比）：淋巴水肿和周围神经病变影响了很大一部分幸存者。需要采取干预措施来减轻这一负担。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Cancer 医学-肿瘤学

CiteScore

13.10

自引率

3.20%

发文量

480

审稿时长

2-3 weeks

期刊介绍： The CANCER site is a full-text, electronic implementation of CANCER, an Interdisciplinary International Journal of the American Cancer Society, and CANCER CYTOPATHOLOGY, a Journal of the American Cancer Society. CANCER publishes interdisciplinary oncologic information according to, but not limited to, the following disease sites and disciplines: blood/bone marrow; breast disease; endocrine disorders; epidemiology; gastrointestinal tract; genitourinary disease; gynecologic oncology; head and neck disease; hepatobiliary tract; integrated medicine; lung disease; medical oncology; neuro-oncology; pathology radiation oncology; translational research