Cognitive Impairment in Patients With Breast Cancer Treated With Chemotherapy


Key Points

  • Patients showed significant decline vs controls on multiple tests for memory.
  • Patients also showed significant decline on tests for attention and executive function.

In a study reported in the Journal of Clinical Oncology, Janelsins et al found cognitive impairment in women receiving chemotherapy for breast cancer that persisted for at least 6 months after treatment.

Study Details

The study, conducted within the National Cancer Institute Community Clinical Oncology Research Program, included 580 patients with stage I to IIIC breast cancer from 22 locations nationwide and 363 age-matched controls. Patients were assessed at prechemotherapy, postchemotherapy, and 6 months postchemotherapy time points, with controls assessed at corresponding time points. The primary measure assessed visual memory on the Cambridge Neuropsychological Test Automated Battery Delayed Match to Sample test, using models adjusting for age, education, race, cognitive reserve score, and baseline anxiety and depressive symptoms. Other aspects of memory, attention, and executive function were also assessed.

Cognitive Impairment Over Time

The Delayed Match to Sample test (12-second delay) showed a significant group-by-time effect (P < .005), with patients declining in performance between prechemotherapy and 6 months postchemotherapy (P = .005) and no change being observed among controls (P = .426). Other memory tests showing significant decline for patients vs controls from prechemotherapy to 6 months postchemotherapy were the Cambridge Neuropsychological Test Automated Battery Verbal Recognition Memory test (immediate recall), telephone-based Rey Auditory Verbal Learning Test (immediate and delayed recall), and a single-item memory question.  Among attention tests, patients significantly declined vs controls over this time period on the Rapid Visual Processing test, backward counting, and a single-item question. Among executive function tests, patients significantly declined vs controls on telephone-based digits backward and category fluency tests, as well as a single-item executive function question.

The investigators concluded, “This nationwide study showed [cancer-related cognitive impairment] in patients with breast cancer affects multiple cognitive domains for at least 6 months postchemotherapy.”

The study was supported by grants from the National Cancer Institute.

Michelle C. Janelsins, PhD, MPH, of the University of Rochester Medical Center James P. Wilmot Cancer Institute, is the corresponding author for the Journal of Clinical Oncology article.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.