Cognition affected in subgroups of breast cancer patients

(HealthDay)—Overall, cancer does not seem to affect pretreatment cognition in older women with breast cancer, compared to healthy controls; however, cognition may be affected in some subgroups of breast cancer patients, according to a study published online May 19 in the Journal of Clinical Oncology.

Jeanne S. Mandelblatt, M.D., M.P.H., from Georgetown University in Washington, D.C., and colleagues sought to determine if older patients with breast cancer have cognitive impairment before systemic therapy. Comparisons were made between newly-diagnosed nonmetastatic cancer patients and matched friend or community controls (age, >60 years) free from previous systemic treatment, dementia, or neurologic disease. Surveys and 17 neuropsychological tests were completed.

The researchers found that patients and controls had similar neuropsychological domains, but patients with stage II to III cancers had lower executive function compared with those with stage 0 to I disease, after adjustment (P = 0.05). Among older, nonwhite, less educated women, and those with greater comorbidity, the odds of impairment were significantly higher after adjustment. Comorbidity was strongly associated with impairment among patient cases (adjusted odds ratio, 8.77; P = 0.003), but not among controls (P = 0.97). Specifically, diabetes and cardiovascular disease were associated with impairment among patient cases.

"There were no overall differences between patients with breast cancer and controls before systemic treatment, but there may be pretreatment cognitive impairment within subgroups of patient cases with greater tumor or comorbidity burden," the authors write.

Several authors disclosed financial ties to the diagnostics and pharmaceutical industries.