A 3-year prospective study of the effects of adjuvant treatments on cognition in women with early stage breast cancer

V Jenkins, V Shilling, G Deutsch, D Bloomfield, R Morris, S Allan, H Bishop, N Hodson, S Mitra, G Sadler, E Shah, R Stein, S Whitehead, J Winstanley, V Jenkins, V Shilling, G Deutsch, D Bloomfield, R Morris, S Allan, H Bishop, N Hodson, S Mitra, G Sadler, E Shah, R Stein, S Whitehead, J Winstanley

Abstract

The neuropsychological performance of 85 women with early stage breast cancer scheduled for chemotherapy, 43 women scheduled for endocrine therapy and/or radiotherapy and 49 healthy control subjects was assessed at baseline (T1), postchemotherapy (or 6 months) (T2) and at 18 months (T3). Repeated measures analysis found no significant interactions or main effect of group after controlling for age and intelligence. Using a calculation to examine performance at an individual level, reliable decline on multiple tasks was seen in 20% of chemotherapy patients, 26% of nonchemotherapy patients and 18% of controls at T2 (18%, 14 and 11%, respectively, at T3). Patients who had experienced a treatment-induced menopause were more likely to show reliable decline on multiple measures at T2 (OR=2.6, 95% confidence interval (CI) 0.823-8.266 P=0.086). Psychological distress, quality of life measures and self-reported cognitive failures did not impact on objective tests of cognitive function, but were significantly associated with each other. The results show that a few women experienced objective measurable change in their concentration and memory following standard adjuvant therapy, but the majority were either unaffected or even improve over time.

Figures

Figure 1
Figure 1
Cognitive test battery.

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