Longitudinal assessment of cognitive function in patients with breast cancer and lymphoma receiving chemotherapy
Menée auprès de témoins et de 225 patientes atteintes d'un cancer du sein ou d'un lymphome traités par chimiothérapie, cette étude longitudinale analyse l'évolution des déficiences cognitives jusqu'à 2 ans après les traitements
Background: Cancer-related cognitive impairment is a significant concern, yet data assessing long-term changes from pre-treatment baselines are limited.
Methods: In this large nationwide study, patients with breast cancer and lymphoma and controls were assessed at pre-chemotherapy, post-chemotherapy, 6-month, and 1- and 2-year follow-ups. Cognitive function was measured using self-reported and performance-based assessments. The analysis included 225 participants: breast cancer (41 patients/36 controls) and lymphoma (73 patients/75 controls). Cognitive trajectories were estimated using longitudinal linear mixed models, adjusting for demographic, clinical, and psychosocial factors. A minimal clinically important difference cut-off identified changes over time in perceived cognitive impairment.
Results: Patients with breast cancer reported greater cognitive complaints than controls, with declines in FACT-Cog Total (
β = -17.17, p < .001), Perceived Cognitive Impairment (β = -11.09, p < .001), and Perceived Cognitive Abilities (β = -3.60, p = .03) from pre-chemotherapy to 2-year follow-up. Declines were observed in memory (RAVLT Immediate Recall: β = -1.53, p = .04), and executive function (phone fluency: β = -1.53, p = .02) at 1
year. Patients with lymphoma also showed more complaints, with declines in Perceived Cognitive Impairment (
β = -6.19, p = .01), poorer RAVLT Immediate (β = -1.62, p < .001), Delayed Recall (β = -1.72, p < .001), and phone fluency (β = -2.46, p < .001) from pre-chemotherapy to 1-year follow-up.
Conclusion
:
Compared to controls, patients with breast cancer and lymphoma showed persistent cognitive worsening up to 1-year post-treatment, and patients with breast cancer reported perceived impairment at two years compared to controls.
JNCI Cancer Spectrum , résumé, 2025