Breast Cancer Research and Treatment

, Volume 110, Issue 1, pp 143–152 | Cite as

Cognitive function in breast cancer patients prior to adjuvant treatment

  • Tim A. AhlesEmail author
  • Andrew J. Saykin
  • Brenna C. McDonald
  • Charlotte T. Furstenberg
  • Bernard F. Cole
  • Brett S. Hanscom
  • Tamsin J. Mulrooney
  • Gary N. Schwartz
  • Peter A. Kaufman


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.


Breast cancer Cognitive function Psychological function Neuropsychological testing 



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


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Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Tim A. Ahles
    • 1
    • 2
    Email author
  • Andrew J. Saykin
    • 3
    • 4
  • Brenna C. McDonald
    • 3
    • 4
  • Charlotte T. Furstenberg
    • 1
  • Bernard F. Cole
    • 5
  • Brett S. Hanscom
    • 6
  • Tamsin J. Mulrooney
    • 7
  • Gary N. Schwartz
    • 7
  • Peter A. Kaufman
    • 7
  1. 1.Department of Psychiatry and Center for Psycho-Oncology, The Norris Cotton Cancer CenterDartmouth-Hitchcock Medical Center LebanonLebanonUSA
  2. 2.Department of Psychiatry and Behavioral SciencesMemorial Sloan-Kettering Cancer CenterNew YorkUSA
  3. 3.Department of Psychiatry (Neuropsychology Program)Dartmouth-Hitchcock Medical CenterLebanonUSA
  4. 4.Department of Radiology, Center for Neuroimaging Indiana University School of Medicine IndianapolisIndianapolisUSA
  5. 5.Department of Community and Family Medicine, Dartmouth Medical School and The Norris Cotton Cancer CenterDartmouth-Hitchcock Medical Center LebanonLebanonUSA
  6. 6.Department of OrthopedicsDartmouth-Hitchcock Medical CenterLebanonUSA
  7. 7.Department of Medicine (Medical Oncology)Dartmouth-Hitchcock Medical Center LebanonLebanonUSA

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