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Publications

Multicenter Study Journal Article Research Support, Non-U.S. Gov't Ppublish 22 citations

PubMed: 36571503 DOI: 10.1093/jnci/djac240

Cognitive change in breast cancer patients up to 2 years after diagnosis.

J Natl Cancer Inst 115(3):322-331

Authors: Marie Lange, Sophie Lefevre Arbogast, Isabelle Hardy-Léger, Olivier Rigal, Johan Le Fel, Barbara Pistilli, Jean Petrucci, Christelle Lévy, Aurélie Capel, Charles Coutant, Laure Médeau, Florence Lerebours, Laurence Vanlemmens, Marine Brion, Emmanuelle Bourbouloux, Maxime Blain, Giulia Binarelli, Ines Vaz-Luis, Bénédicte Giffard, Ophélie Querel, Sibille Everhard, Fabrice André, Cécile Charles, Sarah Dauchy, Florence Joly

Affiliations

  • Clinical Research Department, Centre François Baclesse, 14000 Caen, France.
  • Normandie Univ, UNICAEN, INSERM, ANTICIPE, 14000 Caen, France.
  • Cancer and Cognition Platform, Ligue Contre le Cancer, 14000 Caen, France.
  • Equipe Labellisée LIGUE 2022, 14000 Caen, France.
  • CHU Cochin, 75014 Paris, France.
  • Care Support Department, Centre Henri Becquerel, 76000 Rouen, France.
  • Medical Oncology Department, Centre Henri Becquerel, 76000 Rouen, France.
  • Medical Oncology Department, Gustave Roussy, 94800 Villejuif, France.
  • Medical Oncology Department, Institut Curie, 92210 Saint Cloud, France.
  • Institut Normand du Sein, Centre François Baclesse, 14000 Caen, France.
  • Medical Oncology Department, Centre Georges François Leclerc, 21000 Dijon, France.
  • Medical Oncology Department, Centre Oscar Lambret, 59000 Lille, France.
  • Medical Oncology Department, Institut de Cancérologie de l'Ouest, 44805/49100 Nantes/Angers, France.
  • UNIT 981, INSERM, Gustave Roussy, Villejuif, France.
  • Normandie Univ, UNICAEN, PSL University, EPHE, INSERM, U1077, CHU de Caen, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000 Caen, France.
  • UNICANCER, 75654 Paris, France.
  • Université de Bordeaux, Bordeaux Population Health Research Center, France.
  • Hôpital Hôtel-Dieu, AP-HP, 75004 Paris, France.
  • CHU de Caen, Medical Oncology Department, 14000 Caen, France.

Abstract

BACKGROUND

Using the large nationwide French, national, multicenter, prospective cancer and toxicities (CANTO) cohort, we assessed cognitive functioning change after cancer treatments in a subgroup of breast cancer (BC) patients.

METHODS

We included patients with newly diagnosed invasive stage I-III BC enrolled in the CANTO substudy focused on cognitive evaluation and healthy control women matched for age and education. Episodic and working memory, executive functions, processing speed, attention, self-report cognitive difficulties (SRCD), fatigue, anxiety and depression were assessed with neuropsychological tests and self-report questionnaires before treatment (baseline) and approximately 1 (year 1) and 2 years (year 2) after diagnosis. We used linear mixed models to study changes in cognition and tested the effect of adjuvant chemotherapy.

RESULTS

We studied 276 localized BC patients (62% chemotherapy) compared with 135 healthy controls (HC). After adjustment, patients had lower baseline working memory, processing speed, and attention scores than HC (P ≤ .001), and the difference remained statistically significant over follow-up for working memory and processing speed. Executive function scores were similar between groups at baseline but decreased at year 1 among patients compared with HC (Pchange = .006). This decrease in chemotherapy patients was statistically significant compared with HC scores (Pchange < .001). After adjustment, SRCD were similar between BC patients and HC at baseline but increased in patients after treatment at year 1 (Pchange = .002).

CONCLUSIONS

Cognitive difficulties are an important concern in BC patients, starting at diagnosis. Cancer treatments induce executive function decline and SRCD, which decrease over follow-up.

MeSH

Memory, Short-Term, Breast Neoplasms, Neoplasms, Executive Function, Drug Therapy, Breast, Diagnosis, Therapeutics, Memory, Chemotherapy

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