ABSTRACT
In a case control study, cognitive function was evaluated in breast cancer patients currently receiving adjuvant chemotherapy (31), in breast cancer patients who had completed adjuvant chemotherapy at least one year prior to the study (median: 2 yrs; n = 40), and in healthy control adults (36). Standard dose adjuvant chemotherapy was either oral cyclophosphamide (75 mg/m2) on days one to 14, intravenous epirubicin (60 mg/m2) on days one and eight, and intravenous fluorouracil(500 mg/m2) on days one and eight. Patients received cycles every four weeks for a minimum of eight weeks (two complete cycles). A total of 16 women in the completed chemotherapy group were currently taking tamoxifen and two had previously taken tamoxifen. Patients in the control group were significantly younger than the those who currently were receiving chemotherapy and those who had completed chemotherapy (median: 41.5 yrs vs 49 yrs vs 46 yrs). Significantly more patients in both treatment groups were postmenopausal when compared to the control group (10 vs 29 vs 8, respectively). Cognitive impairment measured via the High Sensitivity Cognitive Screening Test (HSCS) revealed that there was a significant difference in the total median scores between women currently on chemotherapy compared to the control group (37 vs 26), but not compared to the women who had completed chemotherapy (34.5). This data indicated that overall cognitive function was impaired in the women currently receiving chemotherapy. In addition, a significantly higher rate of patients with moderate and severe impairment were in the current and previous chemotherapy groups when compared to controls (48.4% vs 50% vs 11.1 %, respectively). When individual cognitive functions were analyzed, scores indicated that memory
and language were significantly affected in the current chemotherapy group when compared to controls. In addition, there were significant differences for language and visual motor skills between the previous chemotherapy group and controls. However, there were no significant differences between the three groups in mood status, suggesting that cognitive changes were not related to mood disturbances.
