Patients With Breast Cancer Report More Cognitive Difficulties After Chemotherapy

Patients with breast cancer reported substantially more cognitive difficulties up to 6 months after chemotherapy compared with age-matched controls without cancer, according to a study published in the Journal of Clinical Oncology.¹

Cancer-related cognitive impairment (CRCI) is prevalent among survivors of and patients with breast cancer. CRCI can be related to disease, surgery, chemotherapy, radiotherapy, hormonal therapy, and immunotherapy, and includes problems with executive function, attention, and processing speed.

Because some previous CRCI research is limited by small samples, heterogeneous populations, lack of prechemotherapy, use of normative data, and lack of generalizability, researchers sought to evaluate the incidence of CRCI in patients with breast cancer in a large prospective, longitudinal, nationwide study.

For the study, researchers enrolled 581 patients with breast cancer receiving care at community oncology clinics, including 48% who had anthracycline-based chemotherapy, and 364 age-matched noncancer controls. Researchers assessed cognitive function using the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) at prechemotherapy and postchemotherapy and at a 6-month follow-up.

Investigators found that patients reported significantly greater cognitive difficulties on the FACT-Cog total score and 4 subscales from prechemotherapy to postchemotherapy compared with controls, and from prechemotherapy to 6-month follow-up (all P <.001).

Results further showed that increased baseline anxiety and depression and decreased cognitive reserve were significantly associated with lower FACT-Cog total scores in patients from postchemotherapy to 6 months of follow-up.

From prechemotherapy to postchemotherapy and from prechemotherapy to 6-month follow-up, patients with breast cancer were more likely to report a clinically significant decline in self-reported cognitive function than controls.

Although this study, which possesses multiple strengths, suggests that perceived CRCI is a substantial problem for breast cancer survivors, this researcher does not explain the longer-term impact of CRCI assessed by FACT-Cog.

Reference

1. Janelsins MC, Heckler CE, Peppone LJ, et al. Cognitive complaints in survivors of breast cancer after chemotherapy compared with age-matched controls: An analysis from a nationwide, multicenter, prospective longitudinal study. J Clin Oncol. 2016 Dec 28. doi: 10.1200/JCO.2016.68.5826. [Epub ahead of print]