Yarosh Rina A, Nichols Hazel B, Wang Qichen, Hirschey Rachel, Kent Erin E, Carey Lisa A, Hayes Sandra C, Ogunleye Adeyemi A, Troester Melissa A, Butler Eboneé N
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Cancer. 2025 Jan 1;131(1):e35650. doi: 10.1002/cncr.35650. Epub 2024 Nov 17.
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.
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.
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.
Lymphedema and peripheral neuropathy affect a substantial proportion of survivors. Interventions are needed to reduce this burden.
乳腺癌治疗的改善延长了患者生存期，但也产生了长期影响。淋巴水肿和周围神经病变是与治疗相关的后遗症，会持续到癌症幸存者阶段。这些病症的同时出现可能会进一步损害患者的功能健康。很少有研究评估不同幸存者群体中这些病症的负担。
卡罗来纳乳腺癌研究第三阶段纳入了2008年至2013年在北卡罗来纳州被诊断出患有乳腺癌的幸存者。对黑人女性和年轻女性（诊断时年龄<50岁）进行了过度抽样。利用≥10年的随访数据，评估持续性淋巴水肿、周围神经病变及其同时出现的患病率。根据患者和疾病特征评估患病率差异（PD）和95%置信区间（CI）。
共纳入1688名幸存者，诊断后平均随访11.1年（标准差0.6）。持续性淋巴水肿、周围神经病变及其同时出现的患病率分别为18.7%、27.7%和8.8%。接受乳房切除术且切除淋巴结>5个的患者淋巴水肿患病率较高，接受紫杉烷类化疗的女性周围神经病变患病率较高。切除淋巴结>5个的女性（与<5个相比；PD，5.4；95%CI，2.1至8.8）以及接受紫杉烷类化疗的女性（与未接受化疗相比；PD，6.8；95%CI，3.9至9.7）同时出现这两种病症的情况更为常见。黑人女性的淋巴水肿负担（PD，2.7；95%CI，0.9至6.3）和周围神经病变负担（PD，5.8；95%CI，1.7至9.9）高于白人女性。与老年女性相比，年轻女性的淋巴水肿患病率（PD，1.8；95%CI，-1.5至5.1）和周围神经病变患病率（PD，4.6；95%CI，0.8至8.4）有所升高。
淋巴水肿和周围神经病变影响了相当一部分幸存者。需要采取干预措施来减轻这种负担。
