Asian Oncol Nurs.  2013 Mar;13(1):11-17. 10.5388/aon.2013.13.1.11.

Comparison of Climacteric Symptoms and Cognitive Impairment in Breast Cancer Survivors and Healthy Women

• Kim GD
• Chung BY
• Kim KH
• Byun HS
• Choi EH

• KMID: 2269436
• DOI: http://doi.org/10.5388/aon.2013.13.1.11

Abstract

PURPOSE
This study was to compare climacteric symptoms and cognitive impairment in breast cancer survivors (n=51) and healthy women (n=51).
METHODS
This study was conducted from January 4th, 2012 to February 16th, 2012. We individually matched healthy women to breast cancer survivors based on age and education, and assessed a questionnaire regarding climacteric symptoms and cognitive impairment. Data were analyzed by using chi2, t-test, and Pearson correlation with the SPSS/Win 12.0 program.
RESULTS
The average score for the climacteric symptoms (19.71) was significantly different (t=-2.78, p=.006) to the average for the breast cancer survivors (15.53). The average cognitive impairment score for the breast cancer survivors (86.37) was significantly different (t=-2.45, p=.016) to the average score for the healthy women (67.92). The climacteric symptoms score showed a significant relationship with cognitive impairment.
CONCLUSION
These results support that adjuvant chemotherapy and anti-hormone therapy are associated with climacteric symptoms and adverse cognitive effects in breast cancer survivors.

Keyword

Breast Neoplasms; Survivors; Climacteric; Symptoms; Cognitive Disorder

MeSH Terms

Breast
Breast Neoplasms
Chemotherapy, Adjuvant
Climacteric
Female
Humans
Survivors
Surveys and Questionnaires

Figure

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  Fig. 1 Study profile.

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  Fig. 2 Comparison of menopausal symptoms (A) and cognitive impairment (B) between breast cancer survivors and healthy women.

Reference

1. Hess LM, Insel KC. Chemotherapy related change in cognitive function: A conceptual model. Oncol Nurs Forum. 2007. 34:981–994.

2. Brem S, Kumar NB. Management of treatment-related symptoms in patients with breast cancer: Current strategies and future directions. Clin J Oncol Nurs. 2011. 15:63–71.

3. Biglia N, Moggio G, Peano E, Sgandurra P, Ponzone R, Nappi RE, et al. Effects of surgical and adjuvant therapies for breast cancer on sexuality, cognitive functions, and body weight. J Sex Med. 2010. 7:1891–1900.

4. Mols F, Vingerhoets AJ, Coebergh W, Van de Poll-Franse LV. Quality of life among long-term breast cancer survivors: A systematic review. Eur J Cancer. 2005. 41:2613–2619.

5. Vearncombe KJ, Rolfe M, Wright M, Pachana NA, Andrew B, Beadle G. Predictors of cognitive decline after chemotherapy in breast cancer patients. J Int Neuropsychol Soc. 2009. 15:951–962.

6. Weiss B. Evaluation of multiple neurotoxic outcomes in cancer chemotherapy. Adv Exp Med Biol. 2010. 678:96–112.

7. Biegler KA, Chaoul MA, Cohen L. Cancer, cognitive impairment, and mediation. Acta Oncol. 2009. 48:18–26.

8. Von Ah D, Russell KM, Storniolo AM, Carpenter JS. Cognitive dysfunction and it's relationship to quality of life in breast cancer survivors. Oncol Nurs Forum. 2009. 36:326–334.

9. Moon JM. Menopause symptoms, fatigue, and quality of life in post-chemotherapy breast cancer survivors [dissertation]. 2009. Seoul: Yonsei Univ..

10. Jansen CE, Dodd MJ, Miaskowski CA, Dowling GA, Kramer J. Preliminary results of a longitudinal study of changes in cognitive function in breast cancer patients undergoing chemotherapy with doxorubicin and cyclophosphamide. Psychooncology. 2008. 17:1189–1195.

11. Vardy J. Cognitive function in breast cancer survivors. Cancer Treat Res. 2009. 151:387–419.

12. Bender CM, Sereika SM, Berga SL, Vogel VG, Brufsky AM, Paraska K, et al. Cognitive impairment associated with adjuvant therapy in women with breast cancer. Psycho-oncology. 2006. 15:422–430.

13. Hermelink K, Untch M, Lux MP. Cognitive function during neoadjuvant chemotherapy for breast cancer: Results of a prospective, multicenter, longitudinal study. Cancer. 2007. 109:1905–1913.

14. Nelson CJ, Nandy N, Roth AJ. Chemotherapy and cognitive deficit: Mechanisms, findings, and potential interventions. Palliat Support Care. 2007. 5:273–280.

15. Jenkins V, Shilling V, Deutsch G, Bloomfield D, Morris R, Allan S, et al. A 3-year prospective study of the effects of adjuvant treatment on cognition in women with early stage breast cancer. Br J Cancer. 2006. 94:828–834.

16. Calvio L, Peugeot M, Bruns GL, Todd BL, Feuerstein M. Measures of cognitive function and work in occupationally active breast cancer survivors. J Occup Environ Med. 2010. 52:219–227.

17. Shilling V, Jenkins V. Self-reported cognitive problems in women receiving adjuvant therapy for breast cancer. Eur J Oncol Nurs. 2007. 11:6–15.

18. Jansen CE, Miaskowski CA, Dodd MJ, Dowling GA. A meta-analysis of the sensitivity of various neuropsychological test used to detect chemotherapy induced cognitive impairment in patients with breast cancer. Oncol Nurs Forum. 2007. 34:997–1005.

19. Phillips KA, Ribi K, Fisher R. Do aromatase inhibitors have adverse effects on cognitive function? Breast Cancer Res. 2011. 13:203.

20. Falleti MG, Sanfilippo A, Maruff P, Weih L, Phillips KQ. The nature and severity of cognitive impairment associated with adjuvant chemotherapy in women breast cancer: A meta-analysis of the current literature. Brain Cogn. 2005. 59:60–70.

21. Wefel JS, Saleeba AK, Buzdar AU, Meyers CA. Acute and late onset cognitive dysfunction associated with chemotherapy in women with breast cancer. Cancer. 2010. 116:3348–3356.

22. Jo HS, Lee KJ. A comparative study on climacteric symptoms of natural menopausal women and artificial menopausal women. J Korean Acad Nurs. 2001. 31:692–702.

23. Chung BY, Choi EH, Kim GD, Kim KH, Byun HS. Development of the cognitive function scale for breast cancer patients. 2011. Seoul, Korea: Ministry of Education, Science and Technology.

24. Carpenter JS, Johnson DH, Wagner IJ, Andrykowski M. Hot flashes and related outcomes in breast cancer survivors and matched comparison women. Oncol Nurs Forum. 2002. 29:E16–E25.

25. Crandall C, Petersen L, Ganz PA. Association of breast cancer and it's therapy with menopause-related symptoms. Menopause. 2004. 11:519–530.

26. Lejbak L, Vrbancic M, Crossley M. Endocrine therapy is associated with low performance on some estrogen-sensitive cognitive task in postmenopausal women with breast cancer. J Clin Exp Neuropsychol. 2010. 32:836–846.

27. Ganz PA. Breast cancer, menopause, and long term survivorship: Clitical issue for the 21st century. Am J Med. 2005. 118:136–141.

28. Yun MR. Menopausal symptoms and menstrual changes in breast cancer survivors treated with adjuvant chemotherapy [dissertation]. 2004. Seoul: Seoul National Univ..

29. Silverman DHS, Castellon SA, Ganz PA. Cognitive dysfunction associated with chemotherapy for breast cancer. Future Neurol. 2007. 2:271–277.

30. Henderson VW. Cognitive changes after menopause: Influence of estrogen. Clin Obstet Gynecol. 2008. 51:618–626.