More Anxiety Ups Peripheral Neuropathy Risk in Breast Cancer

Key Takeaway

  • Medium to high levels of anxiety increase the risk of chemotherapy-induced peripheral neuropathy (CIPN) in women with breast cancer.

Why This Matters

  • CIPN is a common side effect of taxane-based chemotherapy and has negative effects on treatment, daily functioning, and quality of life.

  • Currently, there are no effective interventions to prevent or treat CIPN.

  • The findings highlight the potential importance of treating anxiety before patients begin chemotherapy to mitigate or possibly prevent CIPN.

Study Design

  • The study included 61 women who received taxane-based neoadjuvant chemotherapy at four hospitals in the Netherlands.

  • The patients completed questionnaires that assessed anxiety and depressive symptoms before, during, and after treatment.

  • Peripheral neuropathy severity was gauged by CIPN20 scores, which ranged from 18 to 76. Higher scores indicate more neuropathy.

  • The researchers used mixed-model analyses to investigate whether medium/high levels of anxiety or depression at baseline increased the risk of CIPN during and after chemotherapy.

Key Results

  • At baseline, 14 women (23%) reported medium/high levels of anxiety, and 31 (51%) reported medium/high levels of depressive symptoms.

  • Overall, the mean difference in CIPN scores between women scoring low and those scoring medium/high on baseline anxiety was 3.52 points.

  • The medium/high baseline anxiety group had significantly higher CIPN scores at baseline as well as during and after chemotherapy, with a further increase in CIPN symptoms 6 months after chemotherapy ended.

  • Less anxious women started with lower CIPN scores, and there was less of an increase in neuropathic symptoms during chemotherapy. Their symptoms did not increase after treatment was completed.

  • No relationship was found between depressive symptoms at baseline and the development of CIPN.

  • Baseline characteristics, such as age, body mass index, smoking status, diabetes, rheumatism, and previous chemotherapy, were not associated with CIPN at baseline.


  • The study was small and had a short follow-up.

  • The researchers do not know whether psychological or biological factors account for the association between anxiety and CIPN.

  • It’s also unclear why depressive symptoms have no impact.


  • No funding for the work was reported, and the authors have disclosed no relevant financial relationships.

This is a summary of a preprint research study, “Symptoms of Anxiety but not Depression Before Start of Taxane-Based Chemotherapy are Associated with Peripheral Neuropathy: A Multicenter Study in Women With Breast Cancer,” led by Chris Hinnen of Leiden University Medical Center in the Netherlands. The study has not been peer reviewed. The full text can be found at

M. Alexander Otto is a physician assistant with a master’s degree in medical science and a journalism degree from Newhouse. He is an award-winning medical journalist who has worked for several major news outlets before joining Medscape and also an MIT Knight Science Journalism fellow. Email: [email protected].

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