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. 2020 Sep;29(9):1759-1766.
doi: 10.1158/1055-9965.EPI-20-0346. Epub 2020 Jul 1.

Cognitive Impairment in Patients with Breast Cancer before Surgery: Results from a CANTO Cohort Subgroup

Marie Lange  1   2   3 , Isabelle Hardy-Léger  4   5 , Idlir Licaj  1   2   3   6 , Barbara Pistilli  4 , Olivier Rigal  7   8 , Johan Le Fel  7 , Christelle Lévy  9 , Aurélie Capel  1 , Charles Coutant  10 , Jonathan Meyer  10 , Florence Lerebours  11 , Jean Petrucci  11 , Laurence Vanlemmens  12 , Marine Brion  12 , Mario Campone  13 , Patrick Soulié  13 , Maxime Blain  13 , Ines Vaz-Luis  14 , Bénédicte Giffard  3   15 , Anne-Laure Martin  16 , Sibille Everhard  16 , Fabrice André  4 , Sarah Dauchy  4 , Florence Joly  17   2   3   18
Affiliations

Cognitive Impairment in Patients with Breast Cancer before Surgery: Results from a CANTO Cohort Subgroup

Marie Lange et al. Cancer Epidemiol Biomarkers Prev. 2020 Sep.

Erratum in

Abstract

Background: Twenty to 30% of patients with breast cancer have cognitive impairment after surgery and before adjuvant treatment, but very few studies have focused on cognition before any treatment. This study used a subgroup of women with newly diagnosed breast cancer from the French cancer and toxicities (CANTO) cohort to describe cognition before any treatment in comparison with a group of healthy controls (HC).

Methods: Cognitive assessment was performed before any breast cancer treatment (surgery or neoadjuvant treatment) on women with newly diagnosed invasive stage I-III breast cancer and HCs. Objective cognitive performance, cognitive complaints, anxiety, depression, and fatigue were assessed. Objective cognitive impairment was defined according to International Cognition and Cancer Task Force recommendations.

Results: Of the 264 included patients with breast cancer (54 ± 11 years) and 132 age-matched HCs (53 ± 9 years), overall objective cognitive impairment was observed in 28% of patients with breast cancer and 8% of HCs (P < 0.001). Cognitive complaints were reported by 24% of patients versus 12% of HCs (P < 0.01). Patients reported significantly more anxiety and emotional and cognitive fatigue than HCs (P < 0.01). After adjustment, significantly more patients with breast cancer had overall objective cognitive impairment than HCs [OR = 3.01; 95% confidence interval (CI): 1.31-6.88] without significant difference between groups for cognitive complaints (OR = 1.38; 95% CI: 0.65-2.92). Cognitive complaints were positively associated with fatigue (OR = 1.03; 95% CI: 1.02-1.05).

Conclusions: In this prospective study, compared with HCs, patients with localized breast cancer had more objective cognitive impairment before any treatment. Cognitive complaints were mostly related to fatigue.

Impact: Baseline assessment before treatment is important to assess the impact of each cancer treatment on cognition.

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