Purpose CIPN is a common toxicity associated with chemotherapy, but researchers rarely study its risk factors, fall risk, and prevalence in long-term breast cancer survivors. We aimed to determine CIPN prevalence, risk factors, and association with psychological distress and falls among long-term breast cancer survivors. Methods We conducted cross-sectional analyses among postmenopausal women with a history of stage I–III breast cancer who received taxane-based chemotherapy. Participants reported neuropathic symptoms of tingling/numbness in hands and/or feet on a 0–10 numerical rating scale. We conducted multivariate logistic regression analyses to evaluate risk factors associated with the presence of CIPN and the relationship between CIPN and anxiety, depression, insomnia, and patient-reported falls. Results Among 296 participants, 173 (58.4%) reported CIPN symptoms, 91 (30.7%) rated their symptoms as mild and 82 (27.7%) rated them moderate to severe. Compared with women of normal weight, being obese was associated with increased risk of CIPN, (adjusted OR 1.94, 95% CI: 1.03–3.65). Patients with CIPN reported greater insomnia severity, anxiety, and depression than those without (all p<0.05). Severity of CIPN was associated with higher rates of falls, with 23.8%, 31.9%, and 41.5% in the “no CIPN,” “mild,” and “moderate-to-severe” groups, respectively, experiencing falls (p=0.028). Conclusions The majority of long-term breast cancer survivors who received taxane-based chemotherapy reported CIPN symptoms; obesity was a significant risk factor. Those with CIPN also reported increased psychological distress and falls. Interventions need to target CIPN and comorbid psychological symptoms, and incorporate fall prevention strategies for aging breast cancer survivors.

Objective Sleep disturbance is a major consequence of hot flashes among breast cancer survivors. This study evaluated the effects of electro-acupuncture vs. gabapentin for sleep disturbances among breast cancer survivors experiencing daily hot flashes. Methods We analyzed data from a randomized controlled trial involving 58 breast cancer survivors experiencing bothersome hot flashes at least two times per day. Participants were randomly assigned to receive eight weeks of electro-acupuncture or daily gabapentin (total dose of 900 mg per day). The primary outcome was change in the total Pittsburgh Sleep Quality Index (PSQI) score between groups at Week 8. Secondary outcomes include specific PSQI domains. Results By the end of treatment at Week 8, the mean reduction in PSQI total score was significantly greater in the electro-acupuncture group as compared to the gabapentin group (−2.6 vs. −0.8, p=0.044). The electro-acupuncture also had improved sleep latency (−0.5 vs. 0.1, p=0.041) and sleep efficiency (−0.6 vs. 0.0, p=0.05) compared to the gabapentin group. By Week 8, the electro-acupuncture group improved sleep duration, sleep disturbance, sleep latency, daytime dysfunction, sleep efficiency, and sleep quality (p<0.05 for all) compared to baseline, whereas the gabapentin group improved in duration and sleep quality only (p<0.05). Conclusions Among women experiencing hot flashes, the effects of electro-acupuncture are comparable to gabapentin for improving sleep quality, specifically in the areas of sleep latency and efficiency. Larger randomized controlled trials with longer follow-ups are needed to confirm this preliminary finding. Clinical Trial Registration NCT01013337

PURPOSE: Arthralgia is common among women with breast cancer on adjuvant aromatase inhibitor (AI) therapy. Pain is associated with falls in the general population; however, little is known about the relationship between arthralgia and falls among AI users. Our objective was to determine whether joint pain severity and interference predict future falls. METHODS: We conducted a prospective cohort study of postmenopausal women with stage I-III estrogen receptor-positive breast cancer who were prescribed a third-generation AI. Arthralgia symptoms were measured at baseline using a modified version of the Brief Pain Inventory. Fall occurrence was obtained at 24-month follow-up. RESULTS: Among 667 participants (median age 63 years, interquartile range 57-69 years), 232 (35%, 95% CI 31% to 39%) reported falls 12-24 months after baseline. Among women who fell, 65 (28%) reported seeking medical assistance. After controlling for multiple fall risk factors, we found significant non-linear associations between baseline joint pain severity and risk of falls

Post-mastectomy pain syndrome (PMPS) is a common and severe neuropathic pain syndrome arising after breast surgery. Since few effective allopathic treatments exist for PMPS, many patients may seek assistance from complementary and alternative medicine. Here, we report a case of a woman with severe and persistent PMPS who was successfully treated with acupuncture.