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Cognitive Impairment in Women With Breast Cancer: Comparison of Adjuvant Therapies

By: Jenna Carter, PhD
Posted: Monday, June 22, 2020

TAILORx has provided a novel opportunity for researchers to analyze the impact of chemotherapy on cancer-related cognitive impairment. The findings revealed that women who received chemotherapy plus endocrine therapy reported more acute cognitive impairments at 3 and 6 months after treatment compared with women who received endocrine therapy alone. However, these differences abated over time, with no significant differences between the groups at 12 months and beyond. These findings were published in the Journal of Clinical Oncology.

“We’ve generally assumed that cognitive impairment is due to chemotherapy,” stated Lynne I. Wagner, PhD, of Wake Forest University, in an ECOG-ACRIN Cancer Research Group press release. “Our findings tell us that hormone therapy may also play a role.”

A subset of 552 women were randomly assigned to chemotherapy plus endocrine therapy or endocrine therapy alone. Cognitive impairment was assessed using the 37-item Functional Assessment of Cancer Therapy–Cognitive Function questionnaire, including the 20-item Perceived Cognitive Impairment scale; at baseline, 3, 6, 12, 24, and 36 months.

Findings revealed those who received both chemotherapy and endocrine therapy reported significantly greater cognitive impairment from baseline to 3 months (linear regression difference in mean PCI, 23.82; P < .001) and 6 months (22.62; P = .02) compared with those given endocrine therapy alone, with no significant differences at 12, 24, and 36 months. Additional analyses revealed no significant interaction between menopausal status and treatment, and no main effects for age (older than 50, 50–65, and older than 65; P = .28) as well as no significant age-by-treatment interactions (P = .34).

“…Our findings underscore the value of precision-guided care in identifying women most likely to benefit from chemotherapy and sparing those who are unlikely to benefit from treatment,” concluded Dr. Wagner and colleagues.

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