Study Observes Cognitive Decline in Older Breast Cancer Survivors

A study published in the Journal of Clinical Oncology found that chemotherapy, hormone therapy, and ApoE genotype were associated with poorer cognitive function in older survivors of breast cancer. 

The researchers included 344 newly diagnosed non-metastatic breast cancer survivors and matched them with 347 controls who did not have cancer. Patients were 60 years or older, did not have dementia or neurologic disease, and were recruited between August 2010 and December 2015. Researchers collected data during pre-systemic treatment or control enrollment and at 12 and 24 months via biospecimens; surveys; self-reported Functional Assessment of Cancer Therapy-Cognitive Function; and neuropsychological tests that measured attention, processing speed, and executive function (APE), as well as learning and memory (LM).  

Treatment was related to longitudinal cognition scores: Survivors who received chemotherapy had increasingly worse APE scores (P=0.05), and those initiating hormonal therapy had lower LM scores at 12 months (P=0.03).  

ApoE genotype impacted cognitive function as well: Only ε4+ survivors receiving hormone therapy had short-term decreases in adjusted LM scores (P=0.03). For APE, the three-way interaction was not significant (P=0.14), but scores were significantly lower for ε4+ survivors who received chemotherapy (−0.40; 95% CI, −0.79-−0.01) at 24 months than ε4+ controls (0.01; 95% CI, 0.16-0.18; P<0.05).  

Increasing age was associated with lower baseline scores on all cognitive measures (P<0.001), and frailty was associated with baseline APE and self-reported decline (P<0.001). 

“These data could inform treatment decision making and survivorship care planning,” the authors concluded. 

Post-menopausal weight loss is linked to a reduced breast cancer risk. 

Mortality is high in nursing home patients who undergo surgery for breast cancer. 

SourceJournal of Clinical Oncology