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‘Chemobrain’ in breast carcinoma?

A prologue

  1. Jeffrey S. Wefel Ph.D.1,
  2. Renato Lenzi M.D.2,
  3. Richard Theriault D.O.3,
  4. Aman U. Buzdar M.D.3,
  5. Scott Cruickshank M.A.4,
  6. Christina A. Meyers Ph.D.1,†,*

Article first published online: 21 JUN 2004

DOI: 10.1002/cncr.20393

Issue

Cancer

Cancer

Volume 101, Issue 3, pages 466–475, 1 August 2004

Additional Information

How to Cite

Wefel, J. S., Lenzi, R., Theriault, R., Buzdar, A. U., Cruickshank, S. and Meyers, C. A. (2004), ‘Chemobrain’ in breast carcinoma?. Cancer, 101: 466–475. doi: 10.1002/cncr.20393

Author Information

  1. 1

    Department of Neuro-Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas

  2. 2

    Department of Gastrointestinal Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas

  3. 3

    Department of Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas

  4. 4

    Scott Cruickshank and Associates, Santa Barbara, California

  1. †

    Fax: (713) 794-4999

*Department of Neuro-Oncology (Box 431), The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030

  1. †

    Fax: (713) 794-4999

Publication History

  1. Issue published online: 19 JUL 2004
  2. Article first published online: 21 JUN 2004
  3. Manuscript Accepted: 30 APR 2004
  4. Manuscript Revised: 22 APR 2004
  5. Manuscript Received: 23 FEB 2004

Funded by

  • Susan G. Komen Foundation

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Keywords:

  • cognition disorders;
  • affect;
  • breast neoplasms;
  • drug therapy

Abstract

BACKGROUND

Chemotherapy-induced cognitive dysfunction in patients with breast carcinoma has been described previously. However, those studies only assessed patients' postchemotherapy cognitive functioning and were not able to determine the relation between cognitive function and other treatments, such as surgery and radiotherapy, that often precede systemic chemotherapy.

METHODS

Eighty-four women with breast carcinoma underwent a comprehensive neuropsychologic evaluation before receiving adjuvant therapy for nonmetastatic primary breast carcinoma.

RESULTS

Before the start of systemic therapy, 35% of women in the current cohort exhibited cognitive impairment. Verbal learning (18%) and memory function (25%) were impaired significantly more frequently relative to normative expectations. Although the impairments were not significant in the women who were examined, nonverbal memory (17%), psychomotor processing speed and attention (13%), confrontational naming (13%), visuoconstruction (13%), and upper-extremity fine motor dexterity (12%) were impaired more frequently than was expected. Affective distress was related significantly to cognitive impairment (Pearson chi-square = 9.90; P = 0.002). Given the conservative statistical approach employed, extent of surgery, hormone replacement therapy history, and current menopausal status failed to achieve statistical significance, but these variables did exhibit provocative trends with respect to cognitive impairment.

CONCLUSIONS

Cognitive impairment frequently is observed before the administration of systemic chemotherapy. Thus, investigations purporting to measure chemotherapy-induced cognitive dysfunction must employ study designs that incorporate prechemotherapy baseline assessments to accurately detect changes in cognitive function that are attributable to chemotherapy. Cancer 2004. © 2004 American Cancer Society.

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