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Long-term cognitive function change among breast cancer survivors

  • Epidemiology
  • Published:
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Abstract

Cognitive decline is a common health problem among breast cancer patients and understanding trajectories of cognitive change following among breast cancer survivors is an important public health goal. We conducted a longitudinal study to investigate the cognitive function changes from 18 month to 3 years after breast cancer diagnosis among participants of the Shanghai Breast cancer survivor study, a population-based cohort study of breast cancer survivors. In our study, we completed cognitive function evaluation for 1,300 breast cancer survivors at the 18th month’s survey and 1,059 at 36th month’s survey, respectively, using a battery of cognitive function measurements. We found the scores in attention and executive function, immediate memory and delayed memory significantly improved from 18 to 36 months after breast cancer diagnosis. The improvements appeared in breast cancer survivors receiving treatments (i.e., surgery, radiotherapy, tamoxifen, or chemotherapy combined with or without tamoxifen), but not in those who received neither chemotherapy nor tamoxifen treatment. The results indicate that cognitive functions, particularly immediate verbal episodic memory, and delayed memory significantly improved among breast cancer survivors from 18 to 36 months after cancer diagnosis. In general, comorbidity was inversely associated with the improvements.

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References

  1. Boyle P, Levin B (eds) (2008) World Cancer Report. International Agency for Research on Cancer, Lyon

    Google Scholar 

  2. Brenner H (2002) Long-term survival rates of cancer survivors achieved by the end of the 20th century: a period analysis. Lancet 360(1131–1135):2002

    Google Scholar 

  3. Shu XO, Zheng Y, Cai H, GuK Chen Z, Zheng W, Lu W (2009) Soy food intake and breast cancer survival. JAMA 302:2437–2443

    Article  PubMed Central  PubMed  Google Scholar 

  4. Wefel JS, Meyers CA (2005) Cancer as a risk factor for dementia: a house built on shifting sand. J Natl Cancer Inst 97:788–789

    Article  PubMed  Google Scholar 

  5. Wefel JS, Lenzi R, Theriault RL, Davis RN, Meyers CA (2004) The cognitive sequelae of standard-dose adjuvant chemotherapy in women with breast carcinoma: results of a prospective, randomized, longitudinal trial. Cancer 100:2292–2299

    Article  CAS  PubMed  Google Scholar 

  6. Bender CM, Sereika SM, Berga SL, Vogel VG, Brufsky AM, Paraska KK, Ryan CM (2006) Cognitive impairment associated with adjuvant therapy in breast cancer. Psycho-oncology 15:422–430

    Article  PubMed  Google Scholar 

  7. Jenkins V, Shilling V, Deutsch G, Bloomfield D, Morris R, Allan S, Bishop H, Hodson N, Mitra S, Sadler G et al (2006) A 3-year prospective study of the effects of adjuvant treatments on cognition in women with early stage breast cancer. Br J Cancer 94:828–834

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  8. Shilling V, Jenkins V, Morris R, Deutsch G, Bloomfield D (2005) The effects of adjuvant chemotherapy on cognition in women with breast cancer–preliminary results of an observational longitudinal study. Breast 14:142–150

    Article  CAS  PubMed  Google Scholar 

  9. Bender CM, Paraska KK, Sereika SM, Ryan CM, Berga SL (2001) Cognitive function and reproductive hormones in adjuvant therapy for breast cancer: a critical review. J Pain Symptom Manage 21:407–424

    Article  CAS  PubMed  Google Scholar 

  10. Asher A (2011) Cognitive Dysfunction Among Cancer Survivors. Am J Phys Med Rehabil 90:S16–S26

    Article  PubMed  Google Scholar 

  11. Hurria A, Somlo G, Ahles T (2007) Renaming ‘Chemobrain’. Cancer Invest 25:373–377

    Article  PubMed  Google Scholar 

  12. Vardy J, Rourke S, Tannock IF (2007) Evaluation of cognitive function associated with chemotherapy: a review of published studies and recommendations for future research. J Clin Oncol 25:2455–2463

    Article  PubMed  Google Scholar 

  13. Argyriou AA, Assimakopoulos K, Iconomou G, Giannakopoulou F, Kalofonos HP (2011) Either called ‘Chemobrain’ or ‘Chemofog’, the long-term chemotherapy-induced cognitive decline in cancer survivors is real. J Pain Symptom Manage 41:126–139

    Article  Google Scholar 

  14. McAllister TW, Ahles TA, Saykin AJ, Ferguson RJ, McDonald BC, Lewis LD, Flashman LA, Rhodes CH (2004) Cognitive effects of cytotoxic cancer chemotherapy: predisposing risk factors and potential treatments. Curr Psychiatry Rep 6:364–371

    Article  PubMed  Google Scholar 

  15. Barton D, Loprinzi C (2002) Novel approaches to preventing chemotherapy-induced cognitive dysfunction in breast cancer: the art of the possible. Clin Breast Cancer 3:S121–S127

    Article  PubMed  Google Scholar 

  16. Conroy SK, McDonald BC, Smith DJ, Moser LR, West JD, Kamendulis LM, Klaunig JE, Champion VL, Unverzagt FW, Saykin AJ (2013) Alterations in brain structure and function in breast cancer survivors: effect of post-chemotherapy interval and relation to oxidative DNA damage. Breast Cancer Res Treat 137:493–502

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  17. Reuter-Lorenz PA, Cimprich B (2013) Cognitive function and breast cancer: promise and potential insights from functional brain imaging. Breast Cancer Res Treat 137:33–43

    Article  CAS  PubMed  Google Scholar 

  18. Avisar A, River Y, Schiff E, Bar-Sela G, Steiner M, Ben-Arye E (2012) Chemotherapy-related cognitive impairment: does integrating complementary medicine have something to add? review of the literature. Breast Cancer Res Treat 136:1–7

    Article  CAS  PubMed  Google Scholar 

  19. Mar Helen G, Fan Nadine Houédé-Tchen, Yi Qi-Long, Chemerynsky I, Downie FP, Sabate K, Tannock IF (2005) Fatigue, menopausal symptoms, and cognitive function in women after adjuvant chemotherapy for breast cancer: 1- and 2-year follow-up of a prospective controlled study. J Clin Oncol 23:8025–8032

    Article  Google Scholar 

  20. Chen Xiaoli, Wei Lu, Ying Zheng GuK, Chen Z, Zheng W, Shu XO (2010) Exercise, tea consumption, and depression among breast cancer survivors. J Clin Oncol 28:991–998

    Article  PubMed Central  PubMed  Google Scholar 

  21. Epplein M, Zheng Y, Zheng W, Chen Z, Gu K, Penson D, Lu W, Shu XO (2011) Quality of Life after Breast Cancer Diagnosis and Survival. J Clin Oncol 29:406–412

    Article  PubMed Central  PubMed  Google Scholar 

  22. Salmon DP, Jin H, Zhang M, Grantc I, Yud E (1995) Neuropsychological assessment of Chinese elderly in the Shanghai Dementia survey. Clin Neuropsychol 9:159–168

    Article  Google Scholar 

  23. Chan AS, Poon MW (1999) Performance of 7- to 95-year-old individuals in a Chinese version of the category fluency test. J Int Neuropsychol Soc 5:525–533

    Article  CAS  PubMed  Google Scholar 

  24. Lee TM, Chan CC (2000) Stroop interference in Chinese and English. J Clin Exp Neuropsychol 22:465–471

    Article  CAS  PubMed  Google Scholar 

  25. He J, Iosif AM, Lee DY, Martinez O, Ding D, Carmichael O, Mortimer JA, Zhao QH, Chu SG, Guo QH et al (2010) Brain morphology and cerebrovascular risk in mild cognitive impairment and dementia: sCOBHI-P study. Arch Neurol 67:1231–1237

    Article  PubMed Central  PubMed  Google Scholar 

  26. Bano D, Agostini M, Melino G, Nicotera P (2011) Ageing, neuronal connectivity and brain disorders: an unsolved ripple effect. Mol Neurobiol. 43:124–130

    Article  CAS  PubMed  Google Scholar 

  27. Cullum S, Huppert FA, McGee M, Dening T, Ahmed A, Paykel ES, Brayne C (2000) Decline across different domains of cognitive function in normal ageing: results of a longitudinal population-based study using CAMCOG. Int J Geriatr Psychiatry 15:853–862

    Article  CAS  PubMed  Google Scholar 

  28. Badgio PC, Worden BL (2007) Cognitive functioning and aging in women. J Women Aging 19:13–30

    Article  PubMed  Google Scholar 

  29. Klepin H, Mohile S, Hurria A (2009) Geriatric assessment in older survivors with breast cancer. J Natl Compr Cancer Netw 7:226–236

    Google Scholar 

  30. Mitsiades N, Correa D, Gross CP, Hurria A, Slovin SF (2008) Cognitive effects of hormonal therapy in older adults. Semin Oncol 35:569–581

    Article  CAS  PubMed  Google Scholar 

  31. Rossi A, Colantuoni G, Maione P, Ferrara C Airoma, G, Barzelloni, M. L., Castaldo, V, Gridelli, C, (2005) Chemotherapy of breast cancer in the elderly. Curr Med Chem 12:297–310

    Article  CAS  PubMed  Google Scholar 

  32. Bourbonniere M, Kagan SH (2004) Nursing intervention and older adults who have cancer: specific science and evidence based practice. Nurs Clin North Am 39:529–543

    Article  PubMed  Google Scholar 

  33. Vodermaier A (2009) Breast cancer treatment and cognitive function: the current state of evidence, underlying mechanisms and potential treatments. Womens Health 5:503–516

    Google Scholar 

  34. Ahles TA, Saykin AJ, McDonald BC, Li Y, Furstenberg CT, Hanscom BS, Mulrooney TJ, Schwartz GN, Kaufman PA (2010) Longitudinal assessment of cognitive changes associated with adjuvant treatment for breast cancer: impact of age and cognitive reserve. J Clin Oncol 28:4434–4440

    Article  PubMed Central  PubMed  Google Scholar 

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Acknowledgments

The authors thank the breast cancer patients who participated in the study and the research staff of the Shanghai Breast Cancer Survivor Study for their dedication and contributions to the study. The parent study was supported by grants from the US Department of Defense Breast Cancer Research Program (Grant DAMD 17-02-1-0607), the National Cancer Institute (Grant R01 CA118229) and The Shanghai Public Health Talented Professional Overseas Training Program. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health.

Conflict of interest

The authors indicated no potential conflicts of interest.

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Authors and Affiliations

  1. Department of Cancer Prevention and Control, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336, China

    Ying Zheng & Pingping Bao

  2. Department of Health Statistics and Social Medicine, School of Public Health, Fudan University, Shanghai, 200032, China

    Jianfeng Luo

  3. Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, 2525 West End Ave, Suite 300, Nashville, TN, 37203-1738, USA

    Hui Cai, Xiao-Ou Shu & Qi Dai

  4. Department of Neurology, Shanghai Hua Shan Hospital, Fudan University, Shanghai, 200051, China

    Zhen Hong & Ding Ding

  5. Division of Critical Care, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, 37203-1738, USA

    James C. Jackson

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  1. Ying Zheng
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  2. Jianfeng Luo
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  4. Hui Cai
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  5. Zhen Hong
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  8. Xiao-Ou Shu
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  9. Qi Dai
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Correspondence to Qi Dai.

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Zheng, Y., Luo, J., Bao, P. et al. Long-term cognitive function change among breast cancer survivors. Breast Cancer Res Treat 146, 599–609 (2014). https://doi.org/10.1007/s10549-014-3044-1

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  • DOI: https://doi.org/10.1007/s10549-014-3044-1

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