Acupuncture for psychoneurological symptoms in breast cancer: Symptom-specific response and sustainability.

Abstract

e24067 Background: Breast cancer survivors receiving adjuvant endocrine therapy often endure persistent psychoneurological symptoms (PNS: pain, fatigue, and sleep disturbance), impairing function and contributing to therapy non-adherence. While acupuncture shows efficacy for symptom relief, response heterogeneity is common and the sustainability of effects remains underexplored. Examining symptom-specific trajectories is critical to evaluating long-term benefits. This study classified individual symptom response patterns to acupuncture in breast cancer survivors and assess the sustainability of treatment effects. Methods: We conducted a secondary analysis of data from a single-arm, Phase II trial (R21 CA277153; PI: Li) involving 42 female early-stage breast cancer survivors with at least two of the three PNS, who completed a 5-week (10-session) semi-standardized acupuncture protocol. Symptoms were measured using PROMIS-29 at Week 0 (T0; baseline), Week 6 (T1; post-treatment), and Week 12 (T2; post-intervention follow-up). We had complete symptom data across the study duration. Individual symptom trajectories were modeled using univariate k-means clustering. Results: For each symptom, a two-group solution was selected based on optimal statistical fit (highest Calinski-Harabasz value) and adequate sample sizes. Subgroups revealed distinct numbers of responders and magnitudes of symptom change at Week 6. Fatigue exhibited the highest number of responders (n=26; mean change -11.4), followed by pain (n=19; -9.1) and sleep disturbance (n=13; -16.3). Trajectory analysis revealed differential sustainability by Week 12. Pain responders showed robust sustainability, maintaining relief post-intervention (Δ T1–T2: -2.6). In contrast, fatigue and sleep disturbance responders regressed toward baseline (Δ T1–T2: Fatigue +1.5; Sleep Disturbance +6.3), indicating a rebound effect following acupuncture cessation. Conclusions: Acupuncture produces heterogeneous responses across PNS. While acupuncture appears to provide consistent long-term effect for pain relief, fatigue and sleep improvements are shorter-lasting. The observed rebound suggests that these symptoms require maintenance sessions or multimodal interventions for breast cancer survivors to achieve sustained benefits. Univariate trajectory analysis. Symptom n T0* T1* T2* Effect (Δ T0–T1)* Sustainability (Δ T1–T2)* Pain Responders 19 60.5 (6.0) 51.4 (7.6) 48.8 (6.6) -9.1 (6.1) -2.6 (7.7) Non-Responders 22 57.1 (10.7) 55.9 (10.1) 56.1 (9.9) -1.2 (2.0) 0.3 (1.3) Fatigue Responders 26 59.5 (7.1) 48.1 (8.7) 49.7 (8.5) -11.4 (5.0) 1.5 (7.1) Non-Responders 15 50.9 (7.0) 50.9 (7.6) 50.1 (6.3) -0.1 (2.5) -0.7 (3.5) Sleep Disturbance Responders 13 61.3 (5.5) 45.0 (6.0) 51.3 (7.8) -16.3 (4.4) 6.3 (9.4) Non-Responders 28 57.0 (5.9) 55.4 (5.6) 53.6 (5.7) -1.6 (3.7) -1.8 (3.9) *Mean T-score (Standard deviation).