Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2015 Aug 1;121(15):2627-36.
doi: 10.1002/cncr.29393. Epub 2015 Apr 23.

Patterns of change in cognitive function with anastrozole therapy

Catherine M Bender  1 , John D Merriman  1 , Amanda L Gentry  1 , Gretchen M Ahrendt  2 , Sarah L Berga  3 , Adam M Brufsky  2 , Frances E Casillo  1 , Meredith M Dailey  1 , Kirk I Erickson  1 , Frances M Kratofil  1 , Priscilla F McAuliffe  2 , Margaret Q Rosenzweig  1 , Christopher M Ryan  1 , Susan M Sereika  1
Affiliations
Observational Study

Patterns of change in cognitive function with anastrozole therapy

Catherine M Bender et al. Cancer. .

Abstract

Background: The purpose of this study was to examine and compare the effects of the first 18 months of anastrozole therapy on cognitive function in women with breast cancer.

Methods: This large, longitudinal cohort study was composed of postmenopausal women with early-stage breast cancer who received chemotherapy plus anastrozole (n = 114) or anastrozole alone (n = 173) and a control group (n = 110). Cognitive function was assessed before systemic therapy and 6, 12, and 18 months after therapy initiation and at comparable time points in controls.

Results: The chemotherapy-anastrozole and anastrozole-alone groups had poorer executive function than the controls at nearly all time points (P < .0001 to P = .09). A pattern of deterioration in working memory and concentration was observed during the first 6 months of anastrozole therapy for the chemotherapy-anastrozole group (P < .0001 and P < .0009, respectively) and the anastrozole-alone group (P = .0008 and P = .0002, respectively). This was followed by improved working memory and concentration from 6 to 12 months in both groups. The anastrozole-alone group had a second decline in working memory and concentration from 12 to 18 months after the initiation of therapy (P < .0001 and P = .02, respectively).

Conclusions: Women with breast cancer had poorer executive functioning from the period before therapy through the entire first 18 months of therapy. A pattern of decline in working memory and concentration with initial exposure to anastrozole was observed. Women receiving anastrozole alone had a second deterioration in working memory and concentration from 12 to 18 months after therapy initiation. The longer term effects (>18 months) of anastrozole on cognitive function remain to be determined.

Keywords: anastrozole; breast cancer; chemotherapy; cognitive function; endocrine therapy.

PubMed Disclaimer

Conflict of interest statement

There are no potential conflicts of interest.

Figures

Figure 1
Figure 1. Hypothesized mechanism, the influence of anastrozole on cognitive function
Figure 2
Figure 2
a–2c Results for the anastrozole alone group were shifted for comparison due to the lack of a pre-chemotherapy assessment in that group. Red indicates exposure to anastrozole. 2a. Group response profile, executive function factor over 18 months. 2b Group response profile, visual working memory factor over 18 months. 2c. Group response profile, concentration factor over 18 months.
See this image and copyright information in PMC

References

    1. Legault C, Maki PM, Resnick SM, Coker L, Hogan P, Bevers TB, Shumaker SA. Effects of tamoxifena and ralixifene on memory and other cognitive abilities: Cognition in the study of tamoxifen and raloxifene. Journal of Clinical Oncology. 2009;31:5144–5152. - PMC - PubMed
    1. Nystedt M, Berglund G, Bolund C, Fornander T, Rutqvist LE. Side effects of adjuvant endocrine treatment in premenopausal breast cancer patients: A prospective randomized study. Journal of Clinical Oncology. 2003;21(9):1836–1844. - PubMed
    1. Hermelink K, Henschel V, Untch M, Bauerfeind I, Lux MP, Munzel K. Short-term effects of treatment-induced hormonal changes on cognitive function in breast cancer patients. Cancer. 2008;113(9):2431–2439. - PubMed
    1. Jenkins V, Shilling V, Fallowfield L, Howell A, Hutton S. Does hormone therapy for the treatment of breast cancer have a detrimental effect on memory and cognition? A Pilot Study. Psycho-Oncology. 2004;13(1):61–66. - PubMed
    1. Phillips KA, Aldridge J, Ribi K, et al. Cognitive function in postmenopausal breast cancer patients one year after completing adjuvant endocrine therapy with letrozole and/or tamoxifen in the BIG 1-98 trial. Breast Cancer Research & Treatment. 2011;126(1):221–226. - PMC - PubMed

Publication types

MeSH terms