The effects of breast cancer treatment on cognitive functions

Abstract

11531 Background: We have started a longitudinal study to investigate if a) the effects of being given a breast cancer (bc) diagnosis may affect cognitive functions in women, b) if adjuvant therapy may have detrimental effects on cognition, c) if subjects with substantial cognitive impairment after therapy may benefit from a cognitive training program. Methods: The study is dimensioned for 140 subjects. The subjects are recruited consecutively and prospectively from the mammography-screening program at Sodersjukhuset, Stockholm. According to the results of the diagnostic process the patients are divided in two main groups by “biological” randomization; healthy subjects and women with bc (n=70 in each group). All participants are examined by a web-based battery of neuropsychological tests at four times: at inclusion and before diagnosis, after diagnosis (two months), after treatment (six months), and follow-up after an additional three months. Subjects who score one standard deviation below the mean compared to baseline, in any of four cognitive domains (response speed, processing speed, memory and attention) after treatment will be offered to participate in a randomized trial of cognitive training versus control. Results: We have so far included 65 subjects. 30 have completed the third test session. Preliminary results show that patients with a recent bc diagnosis and subsequent surgery demonstrate a tendency toward a cognitive decline in attention. There is a significant cognitive decline in memory in the bc group after treatment p=0.029 (repeated measures ANOVA) and inclination of mild impairment in processing speed. Conclusions: The preliminary results may be interpreted to suggest that receiving a bc diagnosis and/or surgery may be associated to a substantial cognitive decline in a subgroup of patients. After six months of treatment a subgroups of patients have a significant decline in memory, which is not dependent on other cognitive functions, depression or anxiety. Women with bc receiving adjuvant chemotherapy often report difficulties with memory, attention and concentration difficulties. We believe that the fact that bc is the most common cancer among women and specially among women of working age in Sweden may, in itself, motivate a study of cognitive effects of its treatment. No significant financial relationships to disclose.