Skip to main content
Top
Published in: Breast Cancer 4/2014

01-07-2014 | Original Article

Cognitive function in women with breast cancer receiving adjuvant chemotherapy and healthy controls

Authors: Noriko Ando-Tanabe, Yumi Iwamitsu, Masaru Kuranami, Shigemi Okazaki, Hiroe Yasuda, Yuki Nakatani, Kenji Yamamoto, Masahiko Watanabe, Hitoshi Miyaoka

Published in: Breast Cancer | Issue 4/2014

Login to get access

Abstract

Background

The aim of this study was to evaluate the impact of chemotherapy and psychological distress on cognitive function in patients with breast cancer receiving chemotherapy compared to healthy controls.

Methods

Eighteen women with non-metastatic breast cancer who have been exposed to chemotherapy were evaluated with a battery of neuropsychological and psychological tests before (time 1) and 1 month after chemotherapy (time 2). Twenty healthy women were assessed at matched intervals.

Results

The relationship between cognitive change and mood change from time 1 to time 2 was compared between breast cancer patients and healthy controls. Independent t tests revealed no differences in change scores for each neuropsychological test and psychological questionnaire between the chemotherapy and control groups. However, in the chemotherapy group, change scores for verbal memory test and executive function test were significantly and negatively correlated with change score for Hospital Anxiety and Depression Scale (HADS)-D (r ≤ −0.498, p < 0.05). Furthermore, change scores for the verbal memory test and processing function test were also significantly and negatively correlated with change score for HADS-A (r ≤ −0.503, p < 0.05). The multiple regression model for the processing function test accounted for a significant amount of variance (model adjusted R 2 = 0.157, p < 0.05), where the standard partial regression coefficient for HADS-A change score was statistically significant (β = −0.441, p < 0.01), whereas the standard partial regression coefficients for the group and for the HADS-D change score were −0.297 (p = 0.071) and 0.026 (p = 0.868), respectively.

Conclusions

Higher psychological distress was associated with poor cognitive function in patients receiving chemotherapy in this study.
Literature
1.
go back to reference Ahles TA, Saykin AJ, Furstenberg CT, Cole B, Mott LA, Skalla K, et al. Neuropsychologic impact of standard-dose systemic chemotherapy in long-term survivors of breast cancer and lymphoma. J Clin Oncol. 2002;20(2):485–93.PubMedCrossRef Ahles TA, Saykin AJ, Furstenberg CT, Cole B, Mott LA, Skalla K, et al. Neuropsychologic impact of standard-dose systemic chemotherapy in long-term survivors of breast cancer and lymphoma. J Clin Oncol. 2002;20(2):485–93.PubMedCrossRef
2.
go back to reference Brezden CB, Phillips KA, Abdolell M, Bunston T, Tannock IF. Cognitive function in breast cancer patients receiving adjuvant chemotherapy. J Clin Oncol. 2000;18(14):2695–701.PubMed Brezden CB, Phillips KA, Abdolell M, Bunston T, Tannock IF. Cognitive function in breast cancer patients receiving adjuvant chemotherapy. J Clin Oncol. 2000;18(14):2695–701.PubMed
3.
go back to reference Eberhardt B, Dilger S, Musial F, Wedding U, Weiss T, Miltner WH. Short-term monitoring of cognitive functions before and during the first course of treatment. J Cancer Res Clin Oncol. 2006;132(4):234–40. doi:10.1007/s00432-005-0070-8.PubMedCrossRef Eberhardt B, Dilger S, Musial F, Wedding U, Weiss T, Miltner WH. Short-term monitoring of cognitive functions before and during the first course of treatment. J Cancer Res Clin Oncol. 2006;132(4):234–40. doi:10.​1007/​s00432-005-0070-8.PubMedCrossRef
5.
go back to reference Schagen SB, Hamburger HL, Muller MJ, Boogerd W, van Dam FS. Neurophysiological evaluation of late effects of adjuvant high-dose chemotherapy on cognitive function. J Neurooncol. 2001;51(2):159–65.PubMedCrossRef Schagen SB, Hamburger HL, Muller MJ, Boogerd W, van Dam FS. Neurophysiological evaluation of late effects of adjuvant high-dose chemotherapy on cognitive function. J Neurooncol. 2001;51(2):159–65.PubMedCrossRef
7.
go back to reference van Dam FS, Schagen SB, Muller MJ, Boogerd W, vd Wall E, Droogleever Fortuyn ME, et al. Impairment of cognitive function in women receiving adjuvant treatment for high-risk breast cancer: high-dose versus standard-dose chemotherapy. J Natl Cancer Inst. 1998; 90(3): 210–8. van Dam FS, Schagen SB, Muller MJ, Boogerd W, vd Wall E, Droogleever Fortuyn ME, et al. Impairment of cognitive function in women receiving adjuvant treatment for high-risk breast cancer: high-dose versus standard-dose chemotherapy. J Natl Cancer Inst. 1998; 90(3): 210–8.
10.
go back to reference Scherwath A, Mehnert A, Schleimer B, Schirmer L, Fehlauer F, Kreienberg R, et al. Neuropsychological function in high-risk breast cancer survivors after stem-cell supported high-dose therapy versus standard-dose chemotherapy: evaluation of long-term treatment effects. Ann Oncol. 2006;17(3):415–23. doi:10.1093/annonc/mdj108.PubMedCrossRef Scherwath A, Mehnert A, Schleimer B, Schirmer L, Fehlauer F, Kreienberg R, et al. Neuropsychological function in high-risk breast cancer survivors after stem-cell supported high-dose therapy versus standard-dose chemotherapy: evaluation of long-term treatment effects. Ann Oncol. 2006;17(3):415–23. doi:10.​1093/​annonc/​mdj108.PubMedCrossRef
11.
go back to reference Bender CM, Sereika SM, Berga SL, Vogel VG, Brufsky AM, Paraska KK, et al. Cognitive impairment associated with adjuvant therapy in breast cancer. Psychooncology. 2006;15(5):422–30. doi:10.1002/pon.964.PubMedCrossRef Bender CM, Sereika SM, Berga SL, Vogel VG, Brufsky AM, Paraska KK, et al. Cognitive impairment associated with adjuvant therapy in breast cancer. Psychooncology. 2006;15(5):422–30. doi:10.​1002/​pon.​964.PubMedCrossRef
12.
go back to reference Jansen CE, Dodd MJ, Miaskowski CA, Dowling GA, Kramer J. Preliminary results of a longitudinal study of changes in cognitive function in breast cancer patients undergoing chemotherapy with doxorubicin and cyclophosphamide. Psychooncology. 2008;17(12):1189–95. doi:10.1002/pon.1342.PubMedCrossRef Jansen CE, Dodd MJ, Miaskowski CA, Dowling GA, Kramer J. Preliminary results of a longitudinal study of changes in cognitive function in breast cancer patients undergoing chemotherapy with doxorubicin and cyclophosphamide. Psychooncology. 2008;17(12):1189–95. doi:10.​1002/​pon.​1342.PubMedCrossRef
14.
go back to reference Stewart A, Collins B, Mackenzie J, Tomiak E, Verma S, Bielajew C. The cognitive effects of adjuvant chemotherapy in early stage breast cancer: a prospective study. Psychooncology. 2008;17(2):122–30. doi:10.1002/pon.1210.PubMedCrossRef Stewart A, Collins B, Mackenzie J, Tomiak E, Verma S, Bielajew C. The cognitive effects of adjuvant chemotherapy in early stage breast cancer: a prospective study. Psychooncology. 2008;17(2):122–30. doi:10.​1002/​pon.​1210.PubMedCrossRef
15.
16.
go back to reference Hermelink K, Untch M, Lux MP, Kreienberg R, Beck T, Bauerfeind I, et al. Cognitive function during neoadjuvant chemotherapy for breast cancer: results of a prospective, multicenter, longitudinal study. Cancer. 2007;109(9):1905–13. doi:10.1002/cncr.22610.PubMedCrossRef Hermelink K, Untch M, Lux MP, Kreienberg R, Beck T, Bauerfeind I, et al. Cognitive function during neoadjuvant chemotherapy for breast cancer: results of a prospective, multicenter, longitudinal study. Cancer. 2007;109(9):1905–13. doi:10.​1002/​cncr.​22610.PubMedCrossRef
17.
go back to reference Mehlsen M, Pedersen AD, Jensen AB, Zachariae R. No indications of cognitive side-effects in a prospective study of breast cancer patients receiving adjuvant chemotherapy. Psychooncology. 2009;18(3):248–57. doi:10.1002/pon.1398.PubMedCrossRef Mehlsen M, Pedersen AD, Jensen AB, Zachariae R. No indications of cognitive side-effects in a prospective study of breast cancer patients receiving adjuvant chemotherapy. Psychooncology. 2009;18(3):248–57. doi:10.​1002/​pon.​1398.PubMedCrossRef
18.
go back to reference Tager FA, McKinley PS, Schnabel FR, El-Tamer M, Cheung YK, Fang Y, et al. The cognitive effects of chemotherapy in post-menopausal breast cancer patients: a controlled longitudinal study. Breast Cancer Res Treat. 2010;123(1):25–34. doi:10.1007/s10549-009-0606-8.PubMedCrossRef Tager FA, McKinley PS, Schnabel FR, El-Tamer M, Cheung YK, Fang Y, et al. The cognitive effects of chemotherapy in post-menopausal breast cancer patients: a controlled longitudinal study. Breast Cancer Res Treat. 2010;123(1):25–34. doi:10.​1007/​s10549-009-0606-8.PubMedCrossRef
19.
go back to reference McCaffrey RJ, Duff K, Westervelt HJ. Practitioner’s guide to evaluating change with intellectual assessment instruments. NY: Springer; 2000. McCaffrey RJ, Duff K, Westervelt HJ. Practitioner’s guide to evaluating change with intellectual assessment instruments. NY: Springer; 2000.
20.
go back to reference McCaffrey RJ, Duff K, Westervelt HJ. Practitioner’s guide to evaluating change with neuropsychological assessment instruments. NY: Springer; 2000. McCaffrey RJ, Duff K, Westervelt HJ. Practitioner’s guide to evaluating change with neuropsychological assessment instruments. NY: Springer; 2000.
21.
go back to reference Wefel JS, Lenzi R, Theriault RL, Davis RN, Meyers CA. The cognitive sequelae of standard-dose adjuvant chemotherapy in women with breast carcinoma: results of a prospective, randomized, longitudinal trial. Cancer. 2004;100(11):2292–9. doi:10.1002/cncr.20272.PubMedCrossRef Wefel JS, Lenzi R, Theriault RL, Davis RN, Meyers CA. The cognitive sequelae of standard-dose adjuvant chemotherapy in women with breast carcinoma: results of a prospective, randomized, longitudinal trial. Cancer. 2004;100(11):2292–9. doi:10.​1002/​cncr.​20272.PubMedCrossRef
24.
go back to reference Cimprich B, So H, Ronis DL, Trask C. Pre-treatment factors related to cognitive functioning in women newly diagnosed with breast cancer. Psychooncology. 2005;14(1):70–8. doi:10.1002/pon.821.PubMedCrossRef Cimprich B, So H, Ronis DL, Trask C. Pre-treatment factors related to cognitive functioning in women newly diagnosed with breast cancer. Psychooncology. 2005;14(1):70–8. doi:10.​1002/​pon.​821.PubMedCrossRef
26.
go back to reference Buckelew SP, Hannay HJ. Relationships among anxiety, defensiveness, sex, task difficulty, and performance on various neuropsychological tasks. Percept Mot Skills. 1986;63(2 Pt 2):711–8.PubMedCrossRef Buckelew SP, Hannay HJ. Relationships among anxiety, defensiveness, sex, task difficulty, and performance on various neuropsychological tasks. Percept Mot Skills. 1986;63(2 Pt 2):711–8.PubMedCrossRef
27.
28.
go back to reference Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361–70.PubMedCrossRef Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361–70.PubMedCrossRef
29.
go back to reference Zigmond AS, Snaith RP, Kitamura T. Hospital Anxiety and Depression Scale (HAD scale). Archives of psychiatric diagnostics and clinical evaluation. Seishinka Shindan Gaku. 1993;4(3):371–2. Zigmond AS, Snaith RP, Kitamura T. Hospital Anxiety and Depression Scale (HAD scale). Archives of psychiatric diagnostics and clinical evaluation. Seishinka Shindan Gaku. 1993;4(3):371–2.
30.
go back to reference Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39(2):175–91.PubMedCrossRef Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39(2):175–91.PubMedCrossRef
32.
go back to reference Schilder CM, Seynaeve C, Linn SC, Boogerd W, Beex LV, Gundy CM, et al. Cognitive functioning of postmenopausal breast cancer patients before adjuvant systemic therapy, and its association with medical and psychological factors. Crit Rev Oncol Hematol. 2010;76(2):133–41. doi:10.1016/j.critrevonc.2009.11.001.PubMedCrossRef Schilder CM, Seynaeve C, Linn SC, Boogerd W, Beex LV, Gundy CM, et al. Cognitive functioning of postmenopausal breast cancer patients before adjuvant systemic therapy, and its association with medical and psychological factors. Crit Rev Oncol Hematol. 2010;76(2):133–41. doi:10.​1016/​j.​critrevonc.​2009.​11.​001.PubMedCrossRef
34.
go back to reference Golden CJ, Espe-Pfeifer P, Wachsler-Felder J. Neuropsychological interpretations of objective psychological tests. New York: Kluwer Academic/Plenum; 2000. Golden CJ, Espe-Pfeifer P, Wachsler-Felder J. Neuropsychological interpretations of objective psychological tests. New York: Kluwer Academic/Plenum; 2000.
38.
go back to reference Biringer E, Mykletun A, Dahl AA, Smith AD, Engedal K, Nygaard HA, et al. The association between depression, anxiety, and cognitive function in the elderly general population—the Hordaland Health Study. Int J Geriatr Psychiatry. 2005;20(10):989–97. doi:10.1002/gps.1390.PubMedCrossRef Biringer E, Mykletun A, Dahl AA, Smith AD, Engedal K, Nygaard HA, et al. The association between depression, anxiety, and cognitive function in the elderly general population—the Hordaland Health Study. Int J Geriatr Psychiatry. 2005;20(10):989–97. doi:10.​1002/​gps.​1390.PubMedCrossRef
43.
go back to reference Schilder CM, Seynaeve C, Beex LV, Boogerd W, Linn SC, Gundy CM, et al. Effects of tamoxifen and exemestane on cognitive functioning of postmenopausal patients with breast cancer: results from the neuropsychological side study of the tamoxifen and exemestane adjuvant multinational trial. J Clin Oncol. 2010;28(8):1294–300. doi:10.1200/JCO.2008.21.3553.PubMedCrossRef Schilder CM, Seynaeve C, Beex LV, Boogerd W, Linn SC, Gundy CM, et al. Effects of tamoxifen and exemestane on cognitive functioning of postmenopausal patients with breast cancer: results from the neuropsychological side study of the tamoxifen and exemestane adjuvant multinational trial. J Clin Oncol. 2010;28(8):1294–300. doi:10.​1200/​JCO.​2008.​21.​3553.PubMedCrossRef
44.
go back to reference Hermelink K, Henschel V, Untch M, Bauerfeind I, Lux MP, Munzel K. Short-term effects of treatment-induced hormonal changes on cognitive function in breast cancer patients: results of a multicenter, prospective, longitudinal study. Cancer. 2008;113(9):2431–9. doi:10.1002/cncr.23853.PubMedCrossRef Hermelink K, Henschel V, Untch M, Bauerfeind I, Lux MP, Munzel K. Short-term effects of treatment-induced hormonal changes on cognitive function in breast cancer patients: results of a multicenter, prospective, longitudinal study. Cancer. 2008;113(9):2431–9. doi:10.​1002/​cncr.​23853.PubMedCrossRef
46.
go back to reference Cappiello M, Cunningham RS, Knobf MT, Erdos D. Breast cancer survivors: information and support after treatment. Clin Nurs Res 2007; 16(4): 278–93 (discussion 94–301). doi:10.1177/1054773807306553. Cappiello M, Cunningham RS, Knobf MT, Erdos D. Breast cancer survivors: information and support after treatment. Clin Nurs Res 2007; 16(4): 278–93 (discussion 94–301). doi:10.​1177/​1054773807306553​.
Metadata
Title
Cognitive function in women with breast cancer receiving adjuvant chemotherapy and healthy controls
Authors
Noriko Ando-Tanabe
Yumi Iwamitsu
Masaru Kuranami
Shigemi Okazaki
Hiroe Yasuda
Yuki Nakatani
Kenji Yamamoto
Masahiko Watanabe
Hitoshi Miyaoka
Publication date
01-07-2014
Publisher
Springer Japan
Published in
Breast Cancer / Issue 4/2014
Print ISSN: 1340-6868
Electronic ISSN: 1880-4233
DOI
https://doi.org/10.1007/s12282-012-0405-7

Other articles of this Issue 4/2014

Breast Cancer 4/2014 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine