287P - Cognitive impairment in older breast cancer survivors

Background

In the United States, over 60% of breast cancer survivors are 65 years or older, but little is known about the late effects of therapy. This study evaluated perceived cognitive impairment (PCI) in older breast cancer survivors and whether prior chemotherapy was associated with perceived cognitive outcomes.

Methods

Breast cancer survivors aged 65 years and older, diagnosed 2012-2013, with local and regional stage disease, were identified through the linked Texas Cancer Registry-Medicare dataset. Survivors completed the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog V3) instrument and provided demographic and clinical data and was conducted between April 2018 and October 2019. A PCI sub-score of less than 54 was used to identify cognitive impairment (CI), as this cutoff has shown good ability to discriminate patients with CI. A logistic regression model (including demographics, comorbidity, income, education, and treatment) was used to determine predictors of CI.

Results

Of 4,448 eligible survivors, 1,954 (43.9%) completed the FACT-Cog. Of these, 1,065 respondents completed all questions. Eighty of those 1065 respondents self-reported disease recurrence and were excluded, leaving 985 patients for this study. The median time from diagnosis to survey completion was 68 months (IQR 62-73). Median age at survey completion was 76 years (IQR 73-80). 29% of patients had received adjuvant chemotherapy. Overall, 243 patients (24.7%) reported CI. In the adjusted models, patients who were older than age 80 years were more likely to report CI (OR 1.9, 95% CI 1.2-3.2, vs age 65-69) and those with an income of greater than $100,000 were less likely to report CI (OR 0.41, 95% CI 0.21-0.81, vs income <$19,999). Prior chemotherapy was not a significant predictor of CI (OR 1.3, 95% CI 0.9-1.8).

Conclusions

Adjuvant chemotherapy was not significantly associated with self-reported CI in older breast cancer survivors 5 or 6 years after diagnosis. Further research is needed to determine the long-term impact of cancer treatments, particularly in older cancer survivors.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Cancer Prevention and Research Institute of Texas (CPRIT).

Disclosure

All authors have declared no conflicts of interest.