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Достижения последних лет в усовершенствовании методов лечения рака молочной железы (РМЖ) позволили значительно увеличить общую выживаемость среди пациентов. Наибольшее значение приобретает качество жизни данной категории больных в отдаленных перспективах, на которое не могут не влиять поздние осложнения проведенной ранее гормонотерапии и химиотерапии. Одними из самых распространенных поздних осложнений проведенного лечения по поводу РМЖ, с которыми сталкиваются до 40 % пациентов, являются общая слабость (астения), когнитивные нарушения и периферическая нейропатия. В большинстве случаев данные осложнения самостоятельно разрешаются спустя 2 года после завершения лечения, однако в некоторых ситуациях возможно затяжное течение. Риск миелопролиферативных заболеваний у пациентов, перенесших химиотерапию, повышается в 4,6 раза, по сравнению с общей популяцией, а сроки дебютирования могут варьироваться от 1 до 5 лет. В данном обзоре будут рассмотрены механизмы развития, диагностика, профилактика и методы лечения таких поздних осложнений проведенной химиотерапии и гормонотерапии по поводу РМЖ, как общая слабость, когнитивные нарушения, периферическая нейропатия и индуцированные лечением миелопролиферативные заболевания. Наличие поздних осложнений и необходимость их коррекции определяет необходимость комплексного мультимодального персонализированного подхода к их профилактике, терапии и позволяет добиться стабилизации ремиссии и улучшения качества жизни пациентов.
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