Cognitive effects of hormonal therapy in early stage breast cancer patients: a prospective study.

Full Abstract

OBJECTIVE: The primary purpose of this study was to evaluate the cognitive effects of adjuvant hormonal therapies in breast cancer patients. PARTICIPANTS AND METHODS: Post-menopausal breast cancer patients scheduled to receive tamoxifen (n=31) or anastrozole (n=14) completed neuropsychological testing around the time of commencement of treatment (T1), and again 5-6 months later (T2). A sample of healthy female volunteers (n=28) was tested at comparable intervals. A standardized regression-based approach was used to assess cognitive change. This method uses test/retest scores of the healthy control group to generate an equation that predicts T2 scores from T1 scores. The difference between the predicted and obtained T2 scores divided by the standard error of the estimate produces a deviation score that reflects the discrepancy from the T1-T2 difference scores that would be expected on the basis of practice and error alone. RESULTS: Analysis of individual deviation scores revealed that both the patients taking tamoxifen and those taking anastrozole were more likely than healthy controls to show reliable cognitive decline from T1 to T2 (39, 64, and 7%, respectively). Processing speed and verbal memory were the cognitive domains most affected. CONCLUSION: These data suggest that hormonal therapies exert a subtle negative influence on cognition in breast cancer patients. Further analyses indicated that this effect was not fully accounted for by demographic factors or fatigue. Methodological limitations of the current study are addressed, along with recommendations for future studies in this area.

Author information

Author/s: Collins, Barbara (B); Mackenzie, Joyce (J); Stewart, Angela (A); Bielajew, Catherine (C); Verma, Shailendra (S);

Affiliation: The Ottawa Hospital-Civic Campus, Ottawa, Ont., Canada K1Y 4E9. bcollins(-atsign-)ottawahospital.on.ca

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't

Journal: Psycho-oncology (Psychooncology), published in England. (Language: eng)

Reference: 2009-Aug; vol 18 (issue 8) : pp 811-21

Dates: Created 2009/08/03; Completed 2009/10/20;

PMID: 19085975, status: MEDLINE (last retrieval date: 10/20/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Antineoplastic Agents, Hormonal - adverse effects; therapeutic use
Breast Neoplasms - drug therapy; psychology
Case-Control Studies
Cognition Disorders - chemically induced; diagnosis; psychology
Female
Follow-Up Studies
Humans
Mental Recall - drug effects
Middle Aged

Neoplasms, Hormone-Dependent - drug therapy; psychology
Neuropsychological Tests - statistics & numerical data
Nitriles - adverse effects; therapeutic use
Prospective Studies
Psychometrics
Reaction Time
Receptors, Estrogen - analysis; drug effects
Tamoxifen - adverse effects; therapeutic use
Triazoles - adverse effects; therapeutic use

Associated Chemicals: Antineoplastic Agents, Hormonal (0) ; Nitriles (0) ; Receptors, Estrogen (0) ; Triazoles (0) ; Tamoxifen (10540-29-1) ; anastrozole (120511-73-1)

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