Cognitive function, fatigue and menopausal symptoms in women following adjuvant chemotherapy for breast cancer: One and two year follow-up of a prospective controlled study

Abstract

8001 Background: Previously we reported substantial fatigue and menopausal symptoms in 100 women receiving adjuvant chemotherapy (CT) for breast cancer, as compared to 100 matched normal women (p<0.0001 for both), with 16% of patients (pts) and 4% of controls experiencing moderate-severe cognitive dysfunction (p<0.008; J Clin Oncol 22, 4175–83, 2003). Here we report one and two-year follow-up. Methods: Initially pts receiving adjuvant CT nominated a female acquaintance, matched by age (+/-5yrs), as a control. Patients and controls were evaluated using the High-Sensitivity Cognitive Screen (HSCS), and the FACT-G quality of life (QL) scale, with subscales for menopausal symptoms (FACT-ES) and fatigue (FACT-F). The first evaluation was towards the end of CT, and was repeated one and two years later. Results: One year evaluations are complete (N=89 pts, 81 controls; 11/19 relapsed or withdrew) and 2-year evaluations will be complete by ASCO 2004 (currently 51pts, 51 controls). Patients showed marked improvement from baseline in cognitive function (p<0.0003), QL and fatigue (p<0.0001for both), and had fewer endocrine symptoms (p<0.03). There were still significant differences in fatigue and menopausal symptoms (p<0.0001 for both), between pts and controls, at one year. Tamoxifen was taken by 45 of 89 pts: menopausal symptoms (p<0.008) and fatigue (p=0.06) improved less, and cognitive function more (p=0.03) in pts taking tamoxifen. Conclusions: Cognitive dysfunction, is temporary in most pts; fatigue and menopausal symptoms improve rapidly but remain worse than in control subjects for at least one year. No significant financial relationships to disclose.