Preclinical study

Breast Cancer Research and Treatment

, Volume 123, Issue 1, pp 25-34

The cognitive effects of chemotherapy in post-menopausal breast cancer patients: a controlled longitudinal study

  • Felice A. TagerAffiliated withBehavioral Medicine Program, Department of Psychiatry, College of Physicians and Surgeons, Columbia University Medical CenterHerbert Irving Comprehensive Cancer Center, College of Physicians and Surgeons, Columbia University Medical Center Email author 
  • , Paula S. McKinleyAffiliated withBehavioral Medicine Program, Department of Psychiatry, College of Physicians and Surgeons, Columbia University Medical CenterHerbert Irving Comprehensive Cancer Center, College of Physicians and Surgeons, Columbia University Medical Center
  • , Freya R. SchnabelAffiliated withDepartment of Surgical Oncology, New York University Medical Center
  • , Mahmoud El-TamerAffiliated withDepartment of Surgical Oncology, College of Physicians and Surgeons, Columbia University Medical Center
  • , Ying Keun K. CheungAffiliated withDepartments of Epidemiology and Biostatistics, Mailman School of Public Health, Columbia University Medical Center
  • , Yixin FangAffiliated withDepartment of Mathematics and Statistics, Georgia State University
  • , Claire R. GoldenAffiliated withBehavioral Medicine Program, Department of Psychiatry, College of Physicians and Surgeons, Columbia University Medical Center
  • , Margery E. FroschAffiliated withBehavioral Medicine Program, Department of Psychiatry, College of Physicians and Surgeons, Columbia University Medical Center
  • , Ulya HabifAffiliated withBehavioral Medicine Program, Department of Psychiatry, College of Physicians and Surgeons, Columbia University Medical Center
    • , Margaret M. MulliganAffiliated withBehavioral Medicine Program, Department of Psychiatry, College of Physicians and Surgeons, Columbia University Medical Center
    • , Ivy S. ChenAffiliated withBehavioral Medicine Program, Department of Psychiatry, College of Physicians and Surgeons, Columbia University Medical Center
    • , Dawn L. HershmanAffiliated withDepartment of Medicine, College of Physicians and Surgeons, Columbia University Medical CenterHerbert Irving Comprehensive Cancer Center, College of Physicians and Surgeons, Columbia University Medical CenterDepartments of Epidemiology and Biostatistics, Mailman School of Public Health, Columbia University Medical Center

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Abstract

Studies suggest that adjuvant chemotherapy for early stage breast cancer (BC) is associated with cognitive impairment related to attention, memory, and visuospatial functioning. However, other studies have failed to confirm that relationship. We report one of the first longitudinal, controlled studies of cognitive effects of chemotherapy in older post-menopausal women. Sixty-one post-menopausal women with non-metastatic BC were administered neuropsychological tests before adjuvant therapy (Time1), six months after treatment (Time2), and at a final 6-month follow-up (Time3). Thirty women were treated with chemotherapy; thirty-one women who received no chemotherapy were controls. Cognitive domains measured included motor, language, attention/concentration/working memory, visuospatial, and memory (verbal and visual). Time-by-treatment interaction was significant in the motor domain (P = 0.007) with poorer performance in women treated with chemotherapy. For the other domains, scores did not significantly vary over time by group. In post-menopausal women, chemotherapy was not associated with changes in cognitive function in areas reported by BC survivors: attention, memory, and information processing. Motor slowing in women treated with chemotherapy could be secondary to peripheral neuropathy rather than an indication of more general declines in cognitive processing. Future studies should control for the independent effects of slowed motor functioning when looking to study possible chemotherapy related cognitive processing deficits.

Keywords

Breast cancer Chemotherapy Post-menopausal Cognitive function