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Cognitive function in breast cancer patients prior to adjuvant treatment

  • Epidemiology
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Abstract

Purpose To compare the neuropsychological functioning of breast cancer patients with invasive cancer and noninvasive cancer prior to adjuvant treatment. Patients and Methods Breast cancer patients (N = 132) with invasive (Stages 1–3, N = 110, age = 54.1 ± 8.1) or noninvasive (Stage 0, N = 22, age = 55.8 ± 8.0) disease completed a battery of neuropsychological and psychological instruments following surgery but prior to initiation of chemotherapy, radiation or hormonal therapy. Matched healthy controls (N = 45, age = 52.9 ± 10.0) completed the same battery of instruments. For the patients, data on menstrual status, type of surgery, time of general anesthesia, CBC and platelets, nutritional status (B12 and folate), and thyroid function were collected. Results Comparison of mean neuropsychological test scores revealed that all groups scored within the normal range; however, patients with Stage 1–3 cancer scored significantly lower than healthy controls on the Reaction Time domain (p = 0.005). Using a definition of lower than expected cognitive performance that corrected for misclassification error, Stage 1–3 patients were significantly (p = 0.002) more likely to be classified as having lower than expected overall cognitive performance (22%) as compared to Stage 0 patients (0%) and healthy controls (4%). No differences were observed between patients classified as having lower than expected cognitive performance compared to those classified as normal performance on measures of depression, anxiety, fatigue, menstrual status, surgery/anesthesia or any of the blood work parameters. Conclusion Patients with Stage 1–3 breast cancer were more likely to be classified as having lower than expected cognitive performance prior to adjuvant treatment as compared to Stage 0 patients and healthy controls, although correction for misclassification error produced a lower rate than previously reported.

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Acknowledgement

Supported by grants (R01 CA87845 and R01 CA101318) from the Office of Cancer Survivorship, National Cancer Institute, Bethesda, MD.

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Authors and Affiliations

  1. Department of Psychiatry and Center for Psycho-Oncology, The Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center Lebanon, Lebanon, NH, USA

    Tim A. Ahles & Charlotte T. Furstenberg

  2. Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, 641 Lexington Avenue, 7th Floor, New York, NY, 10022, USA

    Tim A. Ahles

  3. Department of Psychiatry (Neuropsychology Program), Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA

    Andrew J. Saykin & Brenna C. McDonald

  4. Department of Radiology, Center for Neuroimaging, Indiana University School of Medicine Indianapolis, Indianapolis, IN, USA

    Andrew J. Saykin & Brenna C. McDonald

  5. Department of Community and Family Medicine, Dartmouth Medical School and The Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center Lebanon, Lebanon, NH, USA

    Bernard F. Cole

  6. Department of Orthopedics, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA

    Brett S. Hanscom

  7. Department of Medicine (Medical Oncology), Dartmouth-Hitchcock Medical Center Lebanon, Lebanon, NH, USA

    Tamsin J. Mulrooney, Gary N. Schwartz & Peter A. Kaufman

Authors
  1. Tim A. Ahles
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  2. Andrew J. Saykin
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  3. Brenna C. McDonald
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  4. Charlotte T. Furstenberg
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  5. Bernard F. Cole
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  7. Tamsin J. Mulrooney
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Corresponding author

Correspondence to Tim A. Ahles.

Additional information

This manuscript represents original research that has not been published previously. The authors have no financial disclosures to make regarding this study. All methods and procedures were approved by the Institutional Review Board of Dartmouth Medical School and all participants provided informed consent.

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Ahles, T.A., Saykin, A.J., McDonald, B.C. et al. Cognitive function in breast cancer patients prior to adjuvant treatment. Breast Cancer Res Treat 110, 143–152 (2008). https://doi.org/10.1007/s10549-007-9686-5

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  • DOI: https://doi.org/10.1007/s10549-007-9686-5

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