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Lange M, Lefevre Arbogast S, Hardy-Léger I, Rigal O, Le Fel J, Pistilli B, Petrucci J, Lévy C, Capel A, Coutant C, Médeau L, Lerebours F, Vanlemmens L, Brion M, Bourbouloux E, Blain M, Binarelli G, Vaz-Luis I, Giffard B, Querel O, Everhard S, André F, Charles C, Dauchy S, Joly F. Cognitive change in breast cancer patients up to 2 years after diagnosis. J Natl Cancer Inst 2023; 115:322-331. [PMID: 36571503 PMCID: PMC9996221 DOI: 10.1093/jnci/djac240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 10/11/2022] [Accepted: 12/19/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Using the large nationwide French, national, multicenter, prospective cancer and toxicities (CANTO) cohort, we assessed cognitive functioning change after cancer treatments in a subgroup of breast cancer (BC) patients. METHODS We included patients with newly diagnosed invasive stage I-III BC enrolled in the CANTO substudy focused on cognitive evaluation and healthy control women matched for age and education. Episodic and working memory, executive functions, processing speed, attention, self-report cognitive difficulties (SRCD), fatigue, anxiety and depression were assessed with neuropsychological tests and self-report questionnaires before treatment (baseline) and approximately 1 (year 1) and 2 years (year 2) after diagnosis. We used linear mixed models to study changes in cognition and tested the effect of adjuvant chemotherapy. RESULTS We studied 276 localized BC patients (62% chemotherapy) compared with 135 healthy controls (HC). After adjustment, patients had lower baseline working memory, processing speed, and attention scores than HC (P ≤ .001), and the difference remained statistically significant over follow-up for working memory and processing speed. Executive function scores were similar between groups at baseline but decreased at year 1 among patients compared with HC (Pchange = .006). This decrease in chemotherapy patients was statistically significant compared with HC scores (Pchange < .001). After adjustment, SRCD were similar between BC patients and HC at baseline but increased in patients after treatment at year 1 (Pchange = .002). CONCLUSIONS Cognitive difficulties are an important concern in BC patients, starting at diagnosis. Cancer treatments induce executive function decline and SRCD, which decrease over follow-up.
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Affiliation(s)
- Marie Lange
- Clinical Research Department, Centre François Baclesse, 14000 Caen, France
- Normandie Univ, UNICAEN, INSERM, ANTICIPE, 14000 Caen, France
- Cancer and Cognition Platform, Ligue Contre le Cancer, 14000 Caen, France
- Equipe Labellisée LIGUE 2022, 14000 Caen, France
| | - Sophie Lefevre Arbogast
- Clinical Research Department, Centre François Baclesse, 14000 Caen, France
- Normandie Univ, UNICAEN, INSERM, ANTICIPE, 14000 Caen, France
- Cancer and Cognition Platform, Ligue Contre le Cancer, 14000 Caen, France
| | | | - Olivier Rigal
- Care Support Department, Centre Henri Becquerel, 76000 Rouen, France
- Medical Oncology Department, Centre Henri Becquerel, 76000 Rouen, France
| | - Johan Le Fel
- Care Support Department, Centre Henri Becquerel, 76000 Rouen, France
| | - Barbara Pistilli
- Medical Oncology Department, Gustave Roussy, 94800 Villejuif, France
| | - Jean Petrucci
- Medical Oncology Department, Institut Curie, 92210 Saint Cloud, France
| | - Christelle Lévy
- Institut Normand du Sein, Centre François Baclesse, 14000 Caen, France
| | - Aurélie Capel
- Clinical Research Department, Centre François Baclesse, 14000 Caen, France
| | - Charles Coutant
- Medical Oncology Department, Centre Georges François Leclerc, 21000 Dijon, France
| | - Laure Médeau
- Medical Oncology Department, Centre Georges François Leclerc, 21000 Dijon, France
| | | | | | - Marine Brion
- Medical Oncology Department, Centre Oscar Lambret, 59000 Lille, France
| | - Emmanuelle Bourbouloux
- Medical Oncology Department, Institut de Cancérologie de l’Ouest, 44805/49100 Nantes/Angers, France
| | - Maxime Blain
- Medical Oncology Department, Institut de Cancérologie de l’Ouest, 44805/49100 Nantes/Angers, France
| | - Giulia Binarelli
- Normandie Univ, UNICAEN, INSERM, ANTICIPE, 14000 Caen, France
- Cancer and Cognition Platform, Ligue Contre le Cancer, 14000 Caen, France
| | | | - Bénédicte Giffard
- Cancer and Cognition Platform, Ligue Contre le Cancer, 14000 Caen, France
- Normandie Univ, UNICAEN, PSL University, EPHE, INSERM, U1077, CHU de Caen, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000 Caen, France
| | | | | | - Fabrice André
- Medical Oncology Department, Gustave Roussy, 94800 Villejuif, France
| | - Cécile Charles
- Université de Bordeaux, Bordeaux Population Health Research Center, France
| | | | - Florence Joly
- Clinical Research Department, Centre François Baclesse, 14000 Caen, France
- Normandie Univ, UNICAEN, INSERM, ANTICIPE, 14000 Caen, France
- Cancer and Cognition Platform, Ligue Contre le Cancer, 14000 Caen, France
- Equipe Labellisée LIGUE 2022, 14000 Caen, France
- CHU de Caen, Medical Oncology Department, 14000 Caen, France
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