Oncology Section Task Force on Breast Cancer Outcomes: Clinical Measures of Chemotherapy-induced Peripheral Neuropathy—A Systematic Review

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Chemotherapy-induced peripheral neuropathy (CIPN) is a common adverse effect of breast cancer treatment that can limit cancer intervention options, and also impact balance, mobility, and quality of life long after chemotherapy ends. The purpose of this systematic review was to provide physical therapists (PT) with evidence-based recommendations on tools for clinical assessment of CIPN in adult breast cancer survivors.


A team of reviewers identified all published measures of CIPN meeting the criteria of: clinically feasible, addressing the CIPN experience (signs/symptoms/or both), and with published psychometric properties established in survivors of breast cancer, or a cancer for which the same chemotherapy agents are used. Identified measures were then systematically reviewed and scored according to the Breast Cancer EDGE Task Force Rating Scale from 1 (Do Not Recommend) to 4 (Highly Recommend).


Of 11 measures meeting the review criteria, only one, the Functional Assessment of Cancer Therapy/ Gynecologic Oncology Group-Neurotoxicity Scale (FACT/GOG-Ntx) received the highest rating of 4 (highly recommend). The FACT-GOG-Ntx has high clinical utility for PT, well-established psychometric properties, and published validation with chemotherapies used in breast cancer survivors. The 10 remaining measures received ratings of 2 (unable to recommend at this time).


The Oncology Section Breast Cancer EDGE Task Force on Clinical Measures of CIPN recommends the FACT/GOG-Ntx during physical therapy screening or assessment of CIPN in breast cancer survivors who have received neurotoxic chemotherapy; however, it is not recommended for use in isolation. Therapists are encouraged to supplement with further tests and measures to capture sensory, motor, and autonomic deficits specific to each survivor, along with related activity and participation restrictions.

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