title: The cognitive effects of adjuvant chemotherapy in early stage breast cancer: a prospective study.
abstract: OBJECTIVE
  The primary purpose of this study was to evaluate the cognitive effects of adjuvant chemotherapy in post-menopausal breast cancer patients.
  
  
  METHODS
  Breast cancer patients scheduled to receive adjuvant chemotherapy (n = 61) completed comprehensive cognitive testing before and after treatment. A control group of women receiving adjuvant hormonal therapy (n = 51) was tested at comparable intervals.
  
  
  RESULTS
  Mean scores for both patient groups were within the normal range relative to published norms on all cognitive tests at both time points, and generally inclined or stayed the same from baseline to retest in both groups. However, in an analysis of individual change scores, the chemotherapy patients were 3.3 times more likely than the hormonal patients to show reliable cognitive decline (31 and 12%, respectively). Chemotherapy subjects showing decline were less educated and had higher baseline depression scores than their counterparts who did not decline. Working memory was the cognitive domain most vulnerable to the effects of chemotherapy.
  
  
  CONCLUSIONS
  These data support previous findings of a subtle negative influence of chemotherapy on cognitive function in a subgroup of breast cancer patients. The results are discussed in terms of the importance of study design.
authors.affiliation: School of Psychology, University of Ottawa, Ottawa, Ont., Canada.
authors.forename: Angela
authors.initials: A
authors.lastname: Stewart
authors.forename: Barbara
authors.initials: B
authors.lastname: Collins
authors.forename: Joyce
authors.initials: J
authors.lastname: Mackenzie
authors.forename: Eva
authors.initials: E
authors.lastname: Tomiak
authors.forename: Shailendra
authors.initials: S
authors.lastname: Verma
authors.forename: Catherine
authors.initials: C
authors.lastname: Bielajew
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000453:epidemiology*; D017024:Chemotherapy, Adjuvant / Q000706:statistics & numerical data; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology; D004522:Educational Status; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D009483:Neuropsychological Tests; D017698:Postmenopause / Q000523:psychology; D011446:Prospective Studies; D012720:Severity of Illness Index
chemical_list: D000970:Antineoplastic Agents; D018931:Antineoplastic Agents, Hormonal