Abstract 125P
Background
Using the large national CANTO cohort of patients with early breast cancer (BC), we assessed cognitive functioning change after cancer treatments.
Methods
We included patients with newly diagnosed invasive stage I-III BC enrolled in the pre-defined substudy of CANTO focused on cognitive evaluation (CANTO-Cog) and healthy control women (HC) group-matched for age and education. Episodic and working memory, executive functions, processing speed, attention, cognitive complaints (FACT-COG), cognitive fatigue (FA12), anxiety/depression (HADS) were assessed with neuropsychological tests and self-report questionnaires, before treatment (baseline), 3-6 months (M3-6) and 15-18 months (M15-18) after treatment completion. We used linear mixed models to study the change of objective cognitive functions and cognitive complaints by group while adjusting for age, education, neurological/psychiatric previous history, anxiety and cognitive fatigue. We further tested the effect of adjuvant chemotherapy (CT).
Results
We studied 276 localized BC patients who had performed at least one follow-up assessment after baseline (mean age 54±11 years, adjuvant treatments: 94% radiation therapy, 83% hormonotherapy, 62% CT). Patients were compared to 135 matched HC. At all times, patients reported significantly more cognitive fatigue than HC (p=0.002). After adjustments, patients had lower baseline working memory, processing speed and attention scores than HC (all p≤0.001), and the difference remained significant over follow-up. Cognitive complaints were similar between groups at baseline (p=0.23), but increased in patients after treatment (p group x time=0.024). At M3-6, 36% of patients reported clinically significant cognitive complaints vs 13% of HC. In particular, cognitive complaints of patients treated with CT increased after treatment and decreased at M15-18 without return to baseline level (p CT x time<0.001).
Conclusions
Cognitive difficulties are an important concern in BC patients, starting at diagnosis. Chemotherapy induces cognitive complaints within 6 months after treatment completion, which decrease over follow- up without return to baseline level.
Clinical trial identification
NCT01993498.
Editorial acknowledgement
Legal entity responsible for the study
UNICANCER.
Funding
ANR.
Disclosure
All authors have declared no conflicts of interest.