The Nerve of Chemo: Unpacking Chemotherapy-Induced Peripheral Neuropathy in Breast Cancer Survivors

Project Summary Advancements in cancer treatment are enabling breast cancer survivors to live longer, highlighting the need for more research on their ongoing needs after chemotherapy. By 2030, there are expected to be 4.9 million breast cancer survivors in the United States (US). Black women, in particular, face significant differences in breast cancer outcomes compared to other racial and ethnic groups. For example, Black women are frequently diagnosed at later stages, are twice as likely to develop aggressive cancers such as triple-negative breast cancer, which necessitates chemotherapy treatment, and have a 40% higher mortality rate compared to White women. Chemotherapy-induced peripheral neuropathy (CIPN), can be a debilitating side effect following treatment among breast cancer survivors. CIPN symptoms, including numbness, pain, and balance issues, can impede activities of daily living, substantially lower the quality of life, and lead to psychological distress and social isolation among patients. Limited research exists on CIPN presentations among Black breast cancer survivors. Understanding CIPN's impact on treatment decisions and quality of life for Black patients is important to ultimately reducing symptom burden and improving outcomes among survivors. Data on CIPN symptoms, severity, and treatment outcomes are needed to inform clinical interventions and improve patient care. To examine the impact of CIPN on Black breast cancer survivors, this proposed cross-sectional survey study aims to determine CIPN characteristics and severity among N=125 early-stage (stage I-III) Black breast cancer survivors following chemotherapy at a large urban academic medical center in the Southeastern US. Aim 1 will identify CIPN symptoms and severity using patient-reported outcome measures. Aim 2 will examine associations between CIPN severity and physiological, psychological, and social factors. Aim 3 will characterize the occurrence in treatment outcomes, such as chemotherapy dose reductions, dose delays, and treatment discontinuations. This study will illuminate CIPN's impact among Black breast cancer survivors, informing the design of future longitudinal research and interventions to reduce CIPN's impact and improve treatment outcomes. During the conduct of this fellowship, the applicant will pursue a rigorous training plan, under the supervision of an interdisciplinary team of mentors, to cultivate the skills needed to become and independent researcher. This study will provide the initial data to develop a longitudinal cohort of Black breast cancer survivors experiencing CIPN. The proposed fellowship aligns with the National Cancer Institute and the National Institute of Nursing Research’s strategic plans to train the next generation of cancer researchers and strengthen the cancer workforce while reducing symptom burden and optimizing care outcomes among breast cancer survivors.