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Cancer Epidemiology, Biomarkers & Prevention
Cancer Epidemiology, Biomarkers & Prevention
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Cognitive Impairment in Patients with Breast Cancer before Surgery: Results from a CANTO Cohort Subgroup

Marie Lange, Isabelle Hardy-Léger, Idlir Licaj, Barbara Pistilli, Olivier Rigal, Johan Le Fel, Christelle Lévy, Aurélie Capel, Charles Coutant, Jonathan Meyer, Florence Lerebours, Jean Petrucci, Laurence Vanlemmens, Marine Brion, Mario Campone, Patrick Soulié, Maxime Blain, Ines Vaz-Luis, Bénédicte Giffard, Anne-Laure Martin, Sibille Everhard, Fabrice André, Sarah Dauchy and Florence Joly
Marie Lange
1Clinical Research Department, Centre François Baclesse, Caen, France.
2Normandie Univ, UNICAEN, INSERM, ANTICIPE, Caen, France.
3Cancer & Cognition Platform, Ligue Contre le Cancer, Caen, France.
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  • ORCID record for Marie Lange
Isabelle Hardy-Léger
4Gustave Roussy, Villejuif, France.
5CHU Bicetre, Kremlin Bicetre, France.
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Idlir Licaj
1Clinical Research Department, Centre François Baclesse, Caen, France.
2Normandie Univ, UNICAEN, INSERM, ANTICIPE, Caen, France.
3Cancer & Cognition Platform, Ligue Contre le Cancer, Caen, France.
6Department of Community Medicine, Faculty of Health Sciences, The UiT Arctic University of Norway, Tromsø, Norway.
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Barbara Pistilli
4Gustave Roussy, Villejuif, France.
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Olivier Rigal
7Care Support Department, Centre Henri Becquerel, Rouen, France.
8Medical Oncology Department, Centre Henri Becquerel, Rouen, France.
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Johan Le Fel
7Care Support Department, Centre Henri Becquerel, Rouen, France.
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Christelle Lévy
9Breast Committee, Centre François Baclesse, Caen, France.
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Aurélie Capel
1Clinical Research Department, Centre François Baclesse, Caen, France.
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Charles Coutant
10Centre Georges François Leclerc, Dijon, France.
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Jonathan Meyer
10Centre Georges François Leclerc, Dijon, France.
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Florence Lerebours
11Institut Curie, Saint Cloud, France.
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Jean Petrucci
11Institut Curie, Saint Cloud, France.
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Laurence Vanlemmens
12Centre Oscar Lambret, Lille, France.
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Marine Brion
12Centre Oscar Lambret, Lille, France.
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Mario Campone
13Institut de Cancérologie de l'Ouest, Nantes/Angers, France.
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Patrick Soulié
13Institut de Cancérologie de l'Ouest, Nantes/Angers, France.
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Maxime Blain
13Institut de Cancérologie de l'Ouest, Nantes/Angers, France.
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Ines Vaz-Luis
14UNIT 981, INSERM, Gustave Roussy, Villejuif, Île-de-France, France.
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Bénédicte Giffard
3Cancer & Cognition Platform, Ligue Contre le Cancer, Caen, France.
15Normandie Univ, UNICAEN, PSL University, EPHE, INSERM, U1077, CHU de Caen, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France.
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Anne-Laure Martin
16UNICANCER, Paris, France.
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Sibille Everhard
16UNICANCER, Paris, France.
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Fabrice André
4Gustave Roussy, Villejuif, France.
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Sarah Dauchy
4Gustave Roussy, Villejuif, France.
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Florence Joly
1Clinical Research Department, Centre François Baclesse, Caen, France.
2Normandie Univ, UNICAEN, INSERM, ANTICIPE, Caen, France.
3Cancer & Cognition Platform, Ligue Contre le Cancer, Caen, France.
17CHU de Caen, Medical Oncology Department, Caen, France.
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  • For correspondence: f.joly@baclesse.unicancer.fr
DOI: 10.1158/1055-9965.EPI-20-0346 Published September 2020
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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.

Footnotes

  • Note: ClinicalTrials.gov ID: NCT01993498.

  • Cancer Epidemiol Biomarkers Prev 2020;29:1759–66

  • Received March 4, 2020.
  • Revision received April 27, 2020.
  • Accepted June 24, 2020.
  • Published first July 1, 2020.
  • ©2020 American Association for Cancer Research.
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Cancer Epidemiology Biomarkers & Prevention: 29 (9)
September 2020
Volume 29, Issue 9
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Cognitive Impairment in Patients with Breast Cancer before Surgery: Results from a CANTO Cohort Subgroup
Marie Lange, Isabelle Hardy-Léger, Idlir Licaj, Barbara Pistilli, Olivier Rigal, Johan Le Fel, Christelle Lévy, Aurélie Capel, Charles Coutant, Jonathan Meyer, Florence Lerebours, Jean Petrucci, Laurence Vanlemmens, Marine Brion, Mario Campone, Patrick Soulié, Maxime Blain, Ines Vaz-Luis, Bénédicte Giffard, Anne-Laure Martin, Sibille Everhard, Fabrice André, Sarah Dauchy and Florence Joly
Cancer Epidemiol Biomarkers Prev September 1 2020 (29) (9) 1759-1766; DOI: 10.1158/1055-9965.EPI-20-0346

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Cognitive Impairment in Patients with Breast Cancer before Surgery: Results from a CANTO Cohort Subgroup
Marie Lange, Isabelle Hardy-Léger, Idlir Licaj, Barbara Pistilli, Olivier Rigal, Johan Le Fel, Christelle Lévy, Aurélie Capel, Charles Coutant, Jonathan Meyer, Florence Lerebours, Jean Petrucci, Laurence Vanlemmens, Marine Brion, Mario Campone, Patrick Soulié, Maxime Blain, Ines Vaz-Luis, Bénédicte Giffard, Anne-Laure Martin, Sibille Everhard, Fabrice André, Sarah Dauchy and Florence Joly
Cancer Epidemiol Biomarkers Prev September 1 2020 (29) (9) 1759-1766; DOI: 10.1158/1055-9965.EPI-20-0346
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