Memory impairments with adjuvant anastrozole versus tamoxifen in women with early-stage breast cancer.
OBJECTIVE
Hormones have been implicated as modulators of cognitive functioning. For instance, results of our previous work in women with breast cancer showed that cognitive impairment was more severe and involved more memory domains in those who received adjuvant tamoxifen therapy compared with women who received chemotherapy alone or no adjuvant therapy. Recently aromatase inhibitors such as anastrozole have been used in lieu of tamoxifen for the adjuvant treatment of postmenopausal women with hormone receptor-positive, early-stage breast cancer. Plasma estrogen levels are significantly lower in women who receive anastrozole compared with those who receive tamoxifen. We hypothesized, therefore, that anastrozole would have a more profound effect on cognitive function than tamoxifen, a mixed estrogen agonist/antagonist.


METHODS
To test this hypothesis we compared cognitive function in women with early-stage breast cancer who received tamoxifen with those who received anastrozole therapy in a cross-sectional study. We evaluated cognitive function, depression, anxiety, and fatigue in 31 postmenopausal women with early-stage breast cancer who were between the ages of 21 and 65 years and treated with tamoxifen or anastrozole for a minimum of 3 months.


RESULTS
The results showed that women who received anastrozole had poorer verbal and visual learning and memory than women who received tamoxifen.


CONCLUSIONS
Additional, prospective studies are needed to validate and confirm the changes in cognitive function associated with hormone therapy for breast cancer.
Bender
Catherine M
CM
University of Pittsburgh School of Nursing, Pittsburgh, PA 15261, USA. cbe100@pitt.edu
Sereika
Susan M
SM
Brufsky
Adam M
AM
Ryan
Christopher M
CM
Vogel
Victor G
VG
Rastogi
Priya
P
Cohen
Susan M
SM
Casillo
Frances E
FE
Berga
Sarah L
SL
D000328:Adult; D000368:Aged; D000077384:Anastrozole; D047072:Aromatase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D017024:Chemotherapy, Adjuvant; D003071:Cognition; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D009570:Nitriles / Q000008:administration & dosage / Q000627:therapeutic use*; D017698:Postmenopause; D020845:Selective Estrogen Receptor Modulators / Q000008:administration & dosage / Q000627:therapeutic use*; D013629:Tamoxifen / Q000008:administration & dosage / Q000627:therapeutic use*; D014230:Triazoles / Q000008:administration & dosage / Q000627:therapeutic use*
D047072:Aromatase Inhibitors; D009570:Nitriles; D020845:Selective Estrogen Receptor Modulators; D014230:Triazoles; D013629:Tamoxifen; D000077384:Anastrozole