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Hormone therapy with, without chemotherapy linked to cognitive decline in early-stage breast cancer
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Women with early-stage breast cancer who underwent hormone therapy alone, or chemotherapy followed by hormone therapy, were at increased risk for decline in cognitive function, according to results of a prospective study presented at the Breast Cancer Symposium.
No other treatment- or patient-related factors predicted cognitive decline, researchers wrote.
The analysis included 81 women (median age, 54 years; 78% non-Hispanic white) who were scheduled to receive adjuvant therapy for early-stage breast cancer.
Hope S. Rugo
The women were enrolled into one of four groups: chemotherapy alone (n=14); chemotherapy followed by hormone therapy (n=33); hormone therapy alone (n=22); and controls (n=12). All patients underwent a series of objective and subjective cognitive tests at baseline and at specified intervals after the start of treatment. Researchers also performed brain MRI, PET imaging and serum estradiol at baseline and at two specified treatment intervals.
Overall, patients who underwent chemotherapy and hormone therapy were more likely to experience decline in cognitive function than controls (OR=3.15; P=.008). Hormone therapy also was associated with increased risk for cognitive decline (OR=4.94; P=.004).
Serum estradiol, menopausal status and chemotherapy alone were not significant predictors for decline in cognitive function. Depression and fatigue were not associated with declines in objective cognitive function.
“Patients should be aware that hormone therapy may be a risk factor for cognitive deficits, and interventions studies should be designed to focus on this group of patients,” the researchers wrote.
Disclosure: The researchers report no relevant financial disclosures.
For more information:
Rugo HS. Abstract #104. Presented at: Breast Cancer Symposium; Sept. 7-9, 2013; San Francisco.