Patients with Breast Cancer May Experience Cognitive Decline Up to Two Years Post-Treatment

Cancer treatments can cause cognitive impairment in patients with breast cancer and last up to two years after treatment, which can have a negative impact on quality of life, according to recent study results.

“Cancer-related cognitive impairment, which is mainly studied after adjuvant chemotherapy in breast cancer patients, is one of the most frequent (40% to 75% of patients) side effects reported by them,” the study authors wrote. “They report memory, concentration, multitasking and word-finding difficulties and can be reported (for) several years after treatment, with a negative impact on their quality of life.”

The study, which was published by the Oxford University Press, included 276 patients with newly diagnosed localized breast cancer and 135 participants without cancer. Episodic and working memory, executive functions, processing speed, attention, self-reported cognitive difficulties, fatigue, anxiety and depression were assessed before cancer treatment (at baseline), and at one and two years after diagnosis.

At baseline, patients with breast cancer had lower working memory, processing speed and attention scores compared to those without cancer. The difference in working memory and process speed remained significant throughout follow up.

“Thus, cognitive difficulties are an important concern in breast cancer patients starting at diagnosis and persisting for at least two years after diagnosis independently of treatment received,” the study authors explained.

Overall cognitive impairment was reported in 33% of patients after one year, and 29% at two years.

Furthermore, executive function scores were similar in both groups at baseline, but declined at one year for patients with breast cancer. This decrease was significant in patients who received chemotherapy treatment (62% patients).

Self-reported cognitive difficulties were also similar in both groups at baseline but declined after one and two years in patients with breast cancer.

Additionally, anxiety and depression symptoms were similar between both groups, and anxiety decreased between baseline and after one year in patients with breast cancer. Patients with breast cancer also reported more severe cognitive fatigue than those without cancer after one year, but not after two.

The study authors noted that significant factors associated with cognitive domain scores included age and education level. Self-reported cognitive decline was significantly associated with psychotropic medications, cognitive failure and anxiety.

“Cognitive difficulties are an important concern in breast cancer patients from diagnosis,” the study authors concluded. “This large nationwide cohort study suggest that cancer treatments may induce executive function decline and self-reported cognitive decline up to two years after diagnosis. These findings need to be confirming with larger studies. Furthermore, interventions should be developed in clinical practice to reduce cancer-related cognitive impairment and to manage breast cancer patients during the first year of their treatment.”

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