Effect of adjuvant breast cancer chemotherapy on cognitive function from the older patient's perspective.
OBJECTIVE
This longitudinal prospective study describes the older breast cancer patient's perception of the cognitive impact of adjuvant chemotherapy.


METHODS
A total of 50 patients > or =age 65 with stage I to III breast cancer enrolled in this IRB-approved prospective study. Of the 50, 3 refused postchemotherapy testing and 2 had a cerebrovascular accident (CVA) during therapy, leaving 45 evaluable patients. The Squire Memory Self-Rating Questionnaire, given before and 6 months after chemotherapy, measured patients' perceptions of the ability to learn new information, of working memory, and of remote learning capabilities.


RESULTS
Mean age was 70 years (range 65-84). Breast cancer stages were: I (33%), II (64%), III (2%). A 51% (23/45) of study participants perceived a decline in memory from before to 6 months after completion of chemotherapy. Patients who perceived a poorer memory than average before chemotherapy were more likely to report further memory deterioration after chemotherapy (19/30, 63%) than patients who perceived that their memory was average or better than average prior to chemotherapy (4/15, 27%). The memory domain most likely to be perceived as affected was the ability to learn new information (22/45, 49%) compared to remote memory (9/45, 20%) or working memory (13/45, 29%) capabilities.


CONCLUSIONS
Approximately half of these older women perceived a decline in cognitive function from before to 6 months after chemotherapy. This perceived decline in cognitive function was most pronounced in patients with preexisting memory complaints. Further prospective study is needed to confirm these observations, correlate perceived memory changes with objective findings, and identify subgroups at special risk.
Hurria
Arti
A
Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA. hurriaa@mskcc.org
Goldfarb
Shari
S
Rosen
Carol
C
Holland
Jimmie
J
Zuckerman
Enid
E
Lachs
Mark S
MS
Witmer
Matthew
M
van Gorp
Wilfred G
WG
Fornier
Monica
M
D'Andrea
Gabriella
G
Moasser
Mark
M
Dang
Chau
C
Van Poznak
Catherine
C
Robson
Mark
M
Currie
Violante E
VE
Theodoulou
Maria
M
Norton
Larry
L
Hudis
Clifford
C
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D000970:Antineoplastic Agents / Q000009:adverse effects*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy*; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects* / Q000379:methods*; D003071:Cognition / Q000187:drug effects*; D005260:Female; D006801:Humans; D008568:Memory / Q000187:drug effects
D000970:Antineoplastic Agents