Long-Term Side Effects of Breast Cancer Treatments: A Systematic Review.

BACKGROUND

Breast cancer treatments, including chemotherapy, radiotherapy, endocrine therapy, targeted therapy, and surgical interventions, have significantly improved survival rates. However, these treatments are associated with long-term side effects that can impact the quality of life of survivors. Understanding these adverse effects is crucial for optimizing survivorship care.

METHODS

This systematic review was conducted following PRISMA guidelines to assess the long-term side effects of breast cancer treatments. A comprehensive literature search was performed for studies published between 2005 and 2024. Studies examining long-term (≥ 12 months posttreatment) adverse effects in breast cancer survivors were included, with data extraction and risk of bias assessments conducted by independent reviewers.

RESULTS

The review identified a broad spectrum of long-term side effects, including cardiovascular complications, cognitive impairment, persistent fatigue, lymphedema, menopausal symptoms, and psychological distress. Chemotherapy was frequently associated with peripheral neuropathy and cognitive decline, while radiotherapy increased the risk of fibrosis, secondary malignancies, and ischemic heart disease. Endocrine therapy contributed to osteoporosis, joint pain, and metabolic disturbances, whereas HER2-targeted therapies were linked to cardiotoxicity. In addition, surgical interventions, particularly axillary lymph node dissection, were a primary cause of lymphedema. Psychological distress, including anxiety, depression, and posttraumatic stress disorder, was also prevalent among survivors.

CONCLUSION

The long-term side effects of breast cancer treatments highlight the need for comprehensive survivorship care, including routine monitoring, personalized rehabilitation programs, lifestyle modifications, and psychosocial support. Future research should focus on identifying risk factors, developing targeted interventions, and optimizing treatment strategies to minimize adverse effects and improve the quality of life for breast cancer survivors.