Cognitive functioning before chemotherapy treatment in women with breast cancer

Abstract

548 Background: Many women with breast cancer (BC) undergoing chemotherapy report trouble with attention, concentration and memory. A small body of research suggests that attention, processing speed,and memory tend to be the areas most affected. However,most of the studies have looked at women only after treatment,with no pre-treatment assessment. As part of a longitudinal study, we report here pre-chemotherapy assessments of postmenopausal BC patients. Methods: Thirty-two pre-chemo BC patients (DCIS, Stage I and Stage II) were assessed with a battery of neuro-psychological tests and self-report forms measuring: intelligence, memory, attention, language, visuo-spatial and motor functioning, and mood. Results: Thirteen (40%) women were rated as cognitively impaired based on scoring >1 standard deviation below the mean on two or more tests. When we compared this group to the non-impaired patients, significant differences were seen on a number of tests assessing visual-motor function (Pegboard {P=.001 and .004}, Trailmaking A and B {P=.031, 006},Digit Symbol (P=.015) and Rey {P=.038}), visual memory (BVRT; P=.002)and visual attention(Conner's Continuous Performance Test {Commissions, P=.010; Detectability,P=.022}) independent of age, ethnicity, educational level, and stage of cancer. Conclusions: The results of this study indicate that a significant number of postmenopausal women with BC exhibit objective cognitive deficits pre-treatment in many of the same areas as seen in women after chemotherapy. Thus, to truly understand the cognitive effects of chemotherapy it is necessary to measure pre-treatment functioning in this population to compare with post-treatment changes. In addition,these results may suggest that women with cognitive deficits before chemotherapy may be more vulnerable to the possible effects of chemotherapy and thus be more prone to notice more pronounced changes in their cognitive abilities. No significant financial relationships to disclose.