Memory loss, a hallmark of the chemobrain syndrome, is recognized as one of the most disturbing morbidities associated with cancer treatment. Nowhere is this more evident than in breast cancer patients (BC pts) who have the expectation of long term survival following definitive therapy. At present, this syndrome is poorly understood, and difficult to predict with respect to incidence, duration, and association with other morbidities affecting quality of life. This investigation assessed the incidence of memory loss in BC pts in relation to treatment history and coincidence with other morbidities. The study population consisted of 54 women with BC (age = 52.8 +/-9 yrs) treated between 1997-2005. Treatment consisted of cytotoxic chemotherapy (45/54); hormonal therapy (40/54); and radiation therapy (33/54). BC pts responded to a survey quereying 14 separate morbidities, and were seen during followup visits for documentation of reported morbidities. To investigate relationships with duration off therapy, patients were segregated based on year of treatment completion. Cohort 1 (n=17) finished treatment between 1997-2001; cohort 2 (n=15) between 2002-2003; and, cohort 3 (n=22) between 2004-2005. Overall incidence of memory loss was 17/54 (31.5%). Surprisingly, the frequency of this morbidity was not reduced in pts off therapy for the longest period of time. Thus, memory loss was documented in 35.2% (6/17); 40% 6/15); and 22.7% (5/22) of pts for cohorts 1-3 respectively. Cohort 1 also showed the greatest incidence of neuropathy (41.1%) with coincidence of memory loss and neuropathy occuring in 5 pts. Neuropathy incidence was lower in cohorts 2 (20%) and 3 (13.7%) with 3/6 pts showing coincidence with memory loss. Thus, of the 17 BC pts with memory loss, 47% also developed neuropathy. Of the other morbidities reported, appreciable coincidence with memory loss was found for fatigue (41.1%); sleep disturbances (41.1%); and anxiety/depression (29.4%). Coincidence with at least 2 other morbidities was shown in 82.3% (14/17) of memory loss pts, with 64.7% showing at least 4 morbidities. Memory loss was not attributable to hormonal therapy since 8/17=47% did not receive hormone therapy while 9/17=53% did. It was also not attributable to radiation therapy since 7/17=41% did not receive such treatment while 10/17=59% did. The majority of pts received cytotoxic chemotherapy with various combinations of an anthracycline, cytoxan and a taxane; therefore, it was not surprising that a high percentage of memory loss pts (76.4%) had received one or more of these agents. But it was also noted that 30/44=68% of BC pts treated with these agents did not develop memory loss. The results indicate that memory loss in treated BC pts is not attenuated with increasing time off therapy, and coincides with other morbidities particularly those associated with peripheral and central nervous system functions.
98th AACR Annual Meeting-- Apr 14-18, 2007; Los Angeles, CA