Prospective evaluation of cognitive function in patients with early breast cancer receiving adjuvant chemotherapy

Abstract

Aim:To assess cognitive function prospectively in women with early breast cancer before, during and after the administration of adjuvant chemotherapy. Methods: Between May 2000 and November 2001, 35 assessable patients were entered into the study. Thirty-one received oral cyclophosphamide, methotrexate and 5-fluorouracil (CMF) and four received epirubicin and cyclophosphamide followed by CMF ((cyclophosphamide, methotrexate and 5-fluorouracil)). Testing consisted of the completion of a battery of neuropsychological and psychological inventories and was performed prior to chemotherapy and repeated after 3 (n = 31) and 6 months (n = 30) of chemotherapy and also 6 months after the completion of chemotherapy (n = 27). Results: Prior to chemotherapy a proportion of the patients already exhibited some evidence of impairment of cognitive function. However, on completion of chemotherapy, the neuropsychological scores for shortterm verbal memory and verbal learning were significantly lower than prior to, or 6 months after chemotherapy. In all other domains, cognitive function either remained constant or even appeared to improve. Symptom scales showed that fatigue, nausea and vomiting, constipation and diarrhea were worst half way through the chemotherapy. Quality of life scales indicated that functioning was best after completion of chemotherapy. Conclusion: Patients with early breast cancer may have impaired cognitive function before chemotherapy. Although transient deteriorations in verbal memory and verbal learning were observed on completion of chemotherapy, overall, cognitive function did not decline. It is likely that practice effects influenced our findings.

Prevalence of cognitive impairment and change in patients with breast cancer: A systematic review of longitudinal studies

“…At T0, Cognitive impairment was noted in 25% (125 of 503) of the breast cancer patients and 10% (12 of 120) of the healthy controls at T0 3 26 , 27 , 36–40 Within the patient group, 24% (108 of 446) of the CT patients were labeled as cognitively impaired, , , , , , compared to 30% (17 of 57) of the no‐CT patients. , At T1, 24% (70 of 295) of the breast cancer patients and 10% (10 of 102) of the healthy controls scored cognitively impaired 3 …”

“…At T2, 21% (102 of 479) of the breast cancer patients and 7% (10 of 149) of the healthy controls scored cognitively impaired 27 36 , 38–40 , 43 , 44 Within the patient group, 23% (77 of 336) of the CT patients were labeled as cognitively impaired compared to 18% (25 of 143) of the no‐CT patients. Two studies have separately reported nonsystemic (e.g., RT) treatment showing that 17% (14 of 81) of nonsystemic patients scored cognitively impaired 36 …”

Prevalence of cognitive impairment following chemotherapy treatment for breast cancer: a systematic review and meta-analysis

“…Only prevalence reports from T2 and T3 were subjected to subgroup analyses based on the number of studies contributing data at these time-points, and the number in each analysis when split into sub-groups. At these time-points, four studies were considered to have used less stringent test methods 70 , 75 , 80 , 88 . Heterogeneity remained high after sub-group analysis with the high stringency sub-group having a pooled prevalence of 25% (95% CIs: 16–35), I 2 = 90% at T2, and 23% (95% CIs: 13–34), I 2 = 74% at T3 (Fig.…”

Prevalence of cognitive impairment following chemotherapy treatment for breast cancer: A systematic review and meta-analysis

“…At these time-points, four studies were considered to have used less stringent test methods. [70, 75, 80, 88] Heterogeneity remained high after sub-group analysis with the high stringency sub-group having a pooled prevalence of 25% (95% CIs: 16-35), I 2 = 90% at T2, and 23% (95% CIs: 13-34), I 2 = 74% at T3 (Figure 7).…”