Cognitive Function in Breast Cancer

Patients Receiving Adjuvant Chemotherapy

By Christine B. Brezden, Kelly-Anne Phillips, Mohamed Abdolell, Terry Bunston, Ian F. Tannock From the Department of Medical Oncology and Hematology, Department of Biostatistics, Department of Psychosocial Oncology, Princess Margaret Hospital; and University of Toronto, Toronto, Ontario, Canada. Deceased.

Address reprint requests to Ian F. Tannock, MD, PhD, Department of Medical Oncology, Princess Margaret Hospital, 610 University Ave, Toronto, ON M5G 2M9; email

PURPOSE: Breast cancer patients receiving chemotherapy have complained of difficulties in their ability to remember, think, and concentrate. This study assessed whether there are differences in cognitive function between breast cancer patients treated with standard-dose adjuvant chemotherapy compared with healthy controls.

PATIENTS AND METHODS: The High Sensitivity Cognitive Screen and the Profile of Mood States (POMS) were used to assess cognitive function and mood in a group of 107 women. The women consisted of 31 breast cancer patients receiving adjuvant chemotherapy (group A), 40 breast cancer patients who had completed adjuvant chemotherapy a median of 2 years earlier (group B), and 36 healthy controls (group C).

RESULTS: Univariate analysis showed statistically significant differences (P = .009) in overall cognitive function scores between groups A and C, with poorer function in patients receiving adjuvant chemotherapy. These differences remained significant (P = .046) when controlling for age, education level, and menopausal status. More patients had moderate or severe cognitive impairment in groups A and B than in controls (P .002). There were no significant differences in POMS scores between the groups, suggesting that the differences seen in cognitive scores were unlikely to be because of mood disturbance.

CONCLUSION: Cognitive differences were observed in breast cancer patients receiving adjuvant chemotherapy compared with healthy controls. These differences did not seem to be caused by significant differences in mood disturbance between the two groups. If confirmed, these results have substantial implications for informed consent, counseling, and psychosocial support of patients receiving adjuvant chemotherapy for breast cancer.

C.B.B. and K.A.P. contributed equally to this work.

Other Studies On Chemo Brain

On breast cancer but may apply to any chemo regimen "survivors"

Late Effects of Chemo & Cognitive Function
Adj Chemo & Cognition: Observational Longitudinal Study
Acute & late onset cognitive dysfunction
Neuropsychologic Impact of Standard Dose Systemic Chemo

J Clin Oncol, 2/02

Reuters Health article on this issue
Neurological Complications of Cancer Chemotherapy: REVIEW
Subtle Cognitive Deficits Remain

J Clin Oncol, 1/02

Patient Perspective on Chemotherapy
Radiation Induces Neural Precursor-Cell Dysfunction

Nat Med, 10/02

Current Knowledge/Research Directions-Bca

JNCI, 2/03

Diet in Cognitive Decline

J Neural Transmission, 2/03

Vitamins E & C: Cognitive Function

Am J Clin Nutr, 4/03

Natural & Synthetic Vitamin E (Infants)
Brain Specific Nutrients Reviewed
Abnormal Regional Brain Metabolism After Chemo

Abstract 47 ASCO, 2003

Card Game Tests Cognitive Functions

Br J Anaesthesia, 4/04

Cognitive Functioning Before Chemo: BCa

Abstract # 548 ASCO, 2004

Prospective Evalu Cognitive Function:BCa Adjuv Chemo
Effect of Aromatase Inhibitor on Cognitive Function
Impairment of Cognitive Function F/up Study
Physical Activity, Walking & Cognitive Function: Older Women

Jama, 9/04

Long-term Cognitive Deficits/Dementia From Cancer

JNCI, 6/05

Whole Brain Radiation and Dementia

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