Prospective evaluation of cognitive function in patients with early breast cancer receiving adjuvant chemotherapy

Aim: To assess cognitive function prospectively in women with early breast cancer before, during and after the administration of adjuvant chemotherapy. Methods: Between May 2000 and November 2001, 35 assessable patients were entered into the study. Thirty-one received oral cyclophosphamide, methotrexate and 5-fluorouracil (CMF) and four received epirubicin and cyclophosphamide followed by CMF ((cyclophosphamide, methotrexate and 5-fluorouracil)). Testing consisted of the completion of a battery of neuropsychological and psychological inventories and was performed prior to chemotherapy and repeated after 3 (n = 31) and 6 months (n = 30) of chemotherapy and also 6 months after the completion of chemotherapy (n = 27). Results: Prior to chemotherapy a proportion of the patients already exhibited some evidence of impairment of cognitive function. However, on completion of chemotherapy, the neuropsychological scores for short-term verbal memory and verbal learning were significantly lower than prior to, or 6 months after chemotherapy. In all other domains, cognitive function either remained constant or even appeared to improve. Symptom scales showed that fatigue, nausea and vomiting, constipation and diarrhea were worst half way through the chemotherapy. Quality of life scales indicated that functioning was best after completion of chemotherapy. Conclusion: Patients with early breast cancer may have impaired cognitive function before chemotherapy. Although transient deteriorations in verbal memory and verbal learning were observed on completion of chemotherapy, overall, cognitive function did not decline. It is likely that practice effects influenced our findings.