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Physical and Psychological Burdens Among Breast Cancer Survivors: Evaluating Post-Treatment Gait Impairment, Falls,
Asmaa Namoos1, Nicholas Thomson1, Carol Olson1
1Department of Surgery, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA.
Background:
Breast cancer survivors face a dual burden of physical and psychological challenges, which may persist long after treatment. This study aims to evaluate the physical impairments and psychological outcomes among breast cancer survivors compared to individuals without breast cancer.
Methods:
We conducted a retrospective cohort study using data from 3650 breast cancer survivors and 145,280 individuals without breast cancer from the Virginia Commonwealth University Health System (VCUHS) between January 2024 and 2025. Data were extracted through the TriNetX platform using ICD-10 codes to identify relevant diagnoses and outcomes. Physical outcomes included abnormalities of gait and mobility, unsteadiness on feet, and falls. Psychological outcomes assessed were depression, stress-related disorders, and anxiety following falls. Risk differences, risk ratios (RR), and odds ratios with 95% confidence intervals (CIs) were calculated to compare outcomes between groups.
Results:
Breast cancer survivors exhibited a higher risk of physical impairments compared to nonbreast cancer individuals. The risk of gait and mobility abnormalities was 2.725% in breast cancer survivors versus 1.741% in the comparison group (RR: 1.565; 95% CI: 1.285-1.906; p < 0.0001). Unsteadiness on feet was more prevalent among breast cancer survivors (0.817%) compared to 0.296% in non-cancer individuals (RR: 2.762; 95% CI: 1.91-3.993; p < 0.0001). Additionally, breast cancer survivors had a higher risk of falls (1.644%) compared to nonbreast cancer patients (1.081%) (RR: 1.521; 95% CI: 1.178-1.964; p = 0.0012). Psychologically, breast cancer survivors who experienced falls were more likely to suffer from depression (28.57% vs. 13.1%, p = 0.0002), stress-related disorders (14.29% vs. 3.49%, p < 0.0001), and anxiety (28.57% vs. 15.72%, p = 0.0040) compared to fallers without breast cancer.
Conclusion:
Functional limitations such as unsteadiness and falls are significantly more common among breast cancer survivors and are strongly associated with psychological distress. These findings support mobility impairments as a potential pathway linking cancer treatment to adverse mental health outcomes. Future research should integrate structured ICD-10 data with unstructured oncology notes to enhance fall prediction models and guide personalized survivorship care.
