Chemotherapy-induced peripheral neuropathy and social interaction anxiety in breast cancer patients: a cross-sectional study

BACKGROUND: Breast cancer patients face numerous physical and psychological challenges. Social engagement and psychological adjustment are critical to the quality of life throughout the survival phase. Although chemotherapy-induced peripheral neuropathy and physical handicap are linked to social adjustment, the interplay between these factors in breast cancer patients is unclear. METHODS: This cross-sectional study was conducted between March and September 2025, recruiting 285 breast cancer patients from a Grade A tertiary hospital in central China. Recruitment was conducted using convenience sampling. Data were collected via a structured questionnaire comprising several sections: a demographic and clinical information questionnaire, Chemotherapy Induced Peripheral Neuropathy Assessment Tool、Quick Disabilities of the Arm, Shoulder and Hand Questionnaire、Social Interaction Anxiety Scale. Statistical analysis was performed using SPSS 27.0, including descriptive statistics, univariate analysis and correlation analysis. SPSS PROCESS macro models 4 and 7 were utilised to test the hypothesised pathways between variables. RESULTS: The majority of patients were aged between 40 and 60; the mean ± standard deviation for social interaction anxiety scores was 19.91 ± 13.35. Chemotherapy-induced peripheral neuropathy, as well as disabilities of the arm, shoulder and hand, were found to have a significant positive correlation with social interaction anxiety (all P < 0.05). The results of the mediation and moderation model indicated that disabilities of the arm, shoulder and hand mediated the relationship between chemotherapy-induced peripheral neuropathy and social interaction anxiety, with a significant indirect effect (95% CI: 0.003 to 0.025), accounting for 18.06% of the total effect. The association between chemotherapy-induced peripheral neuropathy and disabilities of the arm, shoulder and hand may be negatively modulated by the neutrophil-to-lymphocyte ratio (95% CI: -0.042 to -0.005). CONCLUSION: There is a direct link between chemotherapy-induced peripheral neuropathy and social interaction anxiety in breast cancer patients, with disabilities of the arm, shoulder and hand acting as a mediator. Focusing on the management of chemotherapy-induced peripheral neuropathy and disabilities of the arm, shoulder and hand may help this population achieve better psychosocial adaptation. Healthcare professionals should think about combining these elements into long-term health management for their patients. However, the negative moderating effect of neutrophil-to-lymphocyte ratio on the link between chemotherapy-induced peripheral neuropathy and disabilities of the arm, shoulder and hand is minor; more scientific research is needed to confirm its clinical significance.