Certain Breast Cancer Survivors May Be at Risk for Cognitive Decline

A study published in the Journal of Clinical Oncology found older breast cancer survivors exhibiting aging-related phenotypes and genotypes may be at increased risk for cognitive decline, according to Healio . "Our study suggests that for most older adults with breast cancer, chemotherapy and hormonal treatments do not have major adverse effects on cognitive function, at least as measured by our current tests," says Georgetown Lombardi Comprehensive Cancer Center Professor Jeanne Mandelblatt. The team assessed the effects of treatment and aging on longitudinal cognitive function among 344 survivors of newly diagnosed nonmetastatic breast cancer compared with 347 healthy controls. They compiled data during presystemic treatment and control enrollment, and via biospecimen collection at one- and two-year follow-up. The outcomes showed women treated with chemotherapy had poorer scores on neuropsychological tests that measured attention, processing speed, and executive function. Moreover, women who initiated hormonal therapy had worse learning and memory scores at one-year follow-up. Group-by-time differences varied by status of apolipoprotein E (APOE4) gene, a risk factor for Alzheimer's that also may be connected to cancer-related cognitive decline. Survivors who tested positive for the APOE4 gene and underwent hormonal therapy had lower adjusted learning and memory scores at one-year follow-up. Meanwhile, two-year scores were significantly lower for survivors who were APOE4 positive and exposed to chemotherapy versus APOE4 positive controls.