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Persistent Cognitive Changes in Breast Cancer Patients 1 Year Following Completion of Chemotherapy

Published online by Cambridge University Press:  15 November 2013

Barbara Collins ,
Joyce MacKenzie ,
Giorgio A. Tasca ,
Carole Scherling  and
Andra Smith
Barbara Collins*
Affiliation:
Psychology Department, The Ottawa Hospital, Ottawa, Ontario, Canada School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
Joyce MacKenzie
Affiliation:
Psychology Department, The Ottawa Hospital, Ottawa, Ontario, Canada
Giorgio A. Tasca
Affiliation:
Psychology Department, The Ottawa Hospital, Ottawa, Ontario, Canada School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
Carole Scherling
Affiliation:
Memory and Aging Centre, University of California, San Francisco (UCSF), San Francisco, California
Andra Smith
Affiliation:
School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
*
Correspondence and reprint requests to: Barbara Collins, The Ottawa Hospital – Civic Campus, 1053 Carling Avenue, Room A628, Ottawa, Ontario, Canada, K1Y 4E9. E-mail: [email protected]
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Abstract

Numerous studies have shown that there are acute cognitive side-effects of chemotherapy for breast cancer. Presumably, patients are more concerned about chronic treatment effects. This report from a prospective longitudinal study compares cognitive functioning in 56 breast cancer patients 1 year after chemotherapy to that of 56 healthy individuals. Neuropsychological test scores were combined into verbal memory, visual memory, working memory, and processing speed scores, as well as an overall summary score, and analyzed using multi-level growth modeling. Frequency of cognitive decline was assessed using regression-based change scores. There was significant rebound in the overall summary score from end of treatment to 1-year follow-up as well as a substantial reduction in the frequency of cognitive decline. However, more than one-third of the breast cancer patients who showed cognitive decline immediately following completion of chemotherapy showed persistent cognitive decline 1 year later. Furthermore, recovery was not seen in all cognitive domains. In fact, the rebound was significant only for working memory. Longer multi-site studies are recommended to explore the risk factors for and the permanence of these longer-term cognitive effects. (JINS, 2013, 20, 1–10)

Keywords

Neuropsychological testsLongitudinal studiesMemoryVerbal learningAnti-estrogensSide effects
Type
Symposia
Information
Journal of the International Neuropsychological Society , Volume 20 , Issue 4 , April 2014 , pp. 370 - 379
Copyright
Copyright © The International Neuropsychological Society 2013 

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