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

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 QuerelSibille Everhard, Fabrice André, Cécile Charles, Sarah Dauchy, Florence Joly

    Résultats de recherche: Contribution à un journalArticleRevue par des pairs

    7 Citations (Scopus)

    Résumé

    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.

    langue originaleAnglais
    Pages (de - à)322-331
    Nombre de pages10
    journalJournal of the National Cancer Institute
    Volume115
    Numéro de publication3
    Les DOIs
    étatPublié - 1 mars 2023

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