Breast Cancer Research and Treatment

, Volume 98, Issue 3, pp 343–348

Effect of adjuvant breast cancer chemotherapy on cognitive function from the older patient’s perspective

  • Arti Hurria
  • Shari Goldfarb
  • Carol Rosen
  • Jimmie Holland
  • Enid Zuckerman
  • Mark S. Lachs
  • Matthew Witmer
  • Wilfred G. van Gorp
  • Monica Fornier
  • Gabriella D’Andrea
  • Mark Moasser
  • Chau Dang
  • Catherine Van Poznak
  • Mark Robson
  • Violante E. Currie
  • Maria Theodoulou
  • Larry Norton
  • Clifford Hudis
Clinical trial

Summary

Purpose

This longitudinal prospective study describes the older breast cancer patient’s perception of the cognitive impact of adjuvant chemotherapy.

Methods

A total of 50 patients ≥age 65 with stage I to III breast cancer enrolled in this IRB-approved prospective study. Of the 50, 3 refused postchemotherapy testing and 2 had a cerebrovascular accident (CVA) during therapy, leaving 45 evaluable patients. The Squire Memory Self-Rating Questionnaire, given before and 6 months after chemotherapy, measured patients’ perceptions of the ability to learn new information, of working memory, and of remote learning capabilities.

Results

Mean age was 70 years (range 65–84). Breast cancer stages were: I (33%), II (64%), III (2%). A 51% (23/45) of study participants perceived a decline in memory from before to 6 months after completion of chemotherapy. Patients who perceived a poorer memory than average before chemotherapy were more likely to report further memory deterioration after chemotherapy (19/30, 63%) than patients who perceived that their memory was average or better than average prior to chemotherapy (4/15, 27%). The memory domain most likely to be perceived as affected was the ability to learn new information (22/45, 49%) compared to remote memory (9/45, 20%) or working memory (13/45, 29%) capabilities.

Conclusion

Approximately half of these older women perceived a decline in cognitive function from before to 6 months after chemotherapy. This perceived decline in cognitive function was most pronounced in patients with preexisting memory complaints. Further prospective study is needed to confirm these observations, correlate perceived memory changes with objective findings, and identify subgroups at special risk.

Keywords

adjuvant chemotherapy cognitive function neuropsychological memory 

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Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Arti Hurria
    • 1
  • Shari Goldfarb
    • 2
  • Carol Rosen
    • 2
  • Jimmie Holland
    • 1
  • Enid Zuckerman
    • 1
  • Mark S. Lachs
    • 3
  • Matthew Witmer
    • 1
  • Wilfred G. van Gorp
    • 4
  • Monica Fornier
    • 1
  • Gabriella D’Andrea
    • 1
  • Mark Moasser
    • 5
  • Chau Dang
    • 1
  • Catherine Van Poznak
    • 1
  • Mark Robson
    • 1
  • Violante E. Currie
    • 1
  • Maria Theodoulou
    • 1
  • Larry Norton
    • 1
  • Clifford Hudis
    • 1
  1. 1.Memorial Sloan-Kettering Cancer CenterNew YorkUSA
  2. 2.New York University Medical CenterNew YorkUSA
  3. 3.Weill Medical College of Cornell UniversityNew YorkUSA
  4. 4.Columbia University, College of Physicians & SurgeonsNew YorkUSA
  5. 5.University of CaliforniaSan FranciscoUSA
  6. 6.Memorial Sloan-Kettering Cancer CenterNew YorkUSA

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