title: A 3-year prospective study of the effects of adjuvant treatments on cognition in women with early stage breast cancer.
abstract: The neuropsychological performance of 85 women with early stage breast cancer scheduled for chemotherapy, 43 women scheduled for endocrine therapy and/or radiotherapy and 49 healthy control subjects was assessed at baseline (T1), postchemotherapy (or 6 months) (T2) and at 18 months (T3). Repeated measures analysis found no significant interactions or main effect of group after controlling for age and intelligence. Using a calculation to examine performance at an individual level, reliable decline on multiple tasks was seen in 20% of chemotherapy patients, 26% of nonchemotherapy patients and 18% of controls at T2 (18%, 14 and 11%, respectively, at T3). Patients who had experienced a treatment-induced menopause were more likely to show reliable decline on multiple measures at T2 (OR=2.6, 95% confidence interval (CI) 0.823-8.266 P=0.086). Psychological distress, quality of life measures and self-reported cognitive failures did not impact on objective tests of cognitive function, but were significantly associated with each other. The results show that a few women experienced objective measurable change in their concentration and memory following standard adjuvant therapy, but the majority were either unaffected or even improve over time.
authors.affiliation: Cancer Research UK Psychosocial Oncology Group, Brighton and Sussex Medical School, University of Sussex, East Sussex BN1 9QG, UK. val@sussex.ac.uk
authors.forename: V
authors.initials: V
authors.lastname: Jenkins
authors.forename: V
authors.initials: V
authors.lastname: Shilling
authors.forename: G
authors.initials: G
authors.lastname: Deutsch
authors.forename: D
authors.initials: D
authors.lastname: Bloomfield
authors.forename: R
authors.initials: R
authors.lastname: Morris
authors.forename: S
authors.initials: S
authors.lastname: Allan
authors.forename: H
authors.initials: H
authors.lastname: Bishop
authors.forename: N
authors.initials: N
authors.lastname: Hodson
authors.forename: S
authors.initials: S
authors.lastname: Mitra
authors.forename: G
authors.initials: G
authors.lastname: Sadler
authors.forename: E
authors.initials: E
authors.lastname: Shah
authors.forename: R
authors.initials: R
authors.lastname: Stein
authors.forename: S
authors.initials: S
authors.lastname: Whitehead
authors.forename: J
authors.initials: J
authors.lastname: Winstanley
mesh_terms: D000328:Adult; D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects* / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000523:psychology* / Q000532:radiotherapy; D016022:Case-Control Studies; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D003072:Cognition Disorders / Q000209:etiology*; D005260:Female; D006801:Humans; D007360:Intelligence; D008569:Memory Disorders / Q000209:etiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D011446:Prospective Studies; D011788:Quality of Life; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D013315:Stress, Psychological
chemical_list: D018931:Antineoplastic Agents, Hormonal