Self-reported cognitive function in older breast cancer survivors after chemotherapy treatment

Purpose: This study evaluated self-reported cognitive function in older breast cancer survivors and its association with prior chemotherapy. Materials and methods: Breast cancer survivors aged 65-years and older, diagnosed 2012–2013, with local and regional stage disease, were identified through the...

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Main Authors: Rachel Kim, Julia Peña, Kai-Ping Liao, Susan K. Peterson, Liang Li, Daria Zorzi, Holly M. Holmes, Mariana Chavez-MacGregor, Sharon H. Giordano
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Breast
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Online Access:http://www.sciencedirect.com/science/article/pii/S0960977625004850
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author Rachel Kim
Julia Peña
Kai-Ping Liao
Susan K. Peterson
Liang Li
Daria Zorzi
Holly M. Holmes
Mariana Chavez-MacGregor
Sharon H. Giordano
author_facet Rachel Kim
Julia Peña
Kai-Ping Liao
Susan K. Peterson
Liang Li
Daria Zorzi
Holly M. Holmes
Mariana Chavez-MacGregor
Sharon H. Giordano
author_sort Rachel Kim
collection DOAJ
description Purpose: This study evaluated self-reported cognitive function in older breast cancer survivors and its association with prior chemotherapy. Materials and methods: Breast cancer survivors aged 65-years and older, diagnosed 2012–2013, with local and regional stage disease, were identified through the linked Texas Cancer Registry-Medicare dataset. Survivors completed the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-CogV3) instrument and provided demographic and clinical data. A PCI--sub-score of less than 54 was used to identify cognitive impairment. Linear regression models were used to examine the FACT-CogV3 primary score, and logistic regression models evaluated the PCI--sub-score. Results: Of 4448 eligible survivors, 1594 (35.8 %) completed the FACT-Cog and 1065 completed all questions. The median time from diagnosis to survey completion was 68 months The median age at survey completion was 76 years. 26 % of patients had received adjuvant chemotherapy. In adjusted models, decreased FACT-Cog primary scores were associated with age 80-years and older (p<0.01 vs. age 65–69) and with depression (p < 0.01), and increased scores were associated with an education of 4-year college and above (p = 0.01).For the PCI-subscale, 243 patients (27.9 %) reported PCI-score <54. In the adjusted models, patients who were older than 80-years were more likely to report perceived cognitive impairment (OR 3.03, vs age 65–69), as well as those with depression (OR 6.19, p < 0.01). Prior chemotherapy was not a significant predictor of PCI (OR 1.49, p = 0.06). Conclusion: Adjuvant chemotherapy was not significantly associated with self-reported cognitive impairment in older breast cancer survivors 5–6 years after diagnosis.
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spelling doaj-art-887efe23c80b418e885a30ef0278871e2025-08-20T03:09:59ZengElsevierBreast1532-30802025-06-018110446810.1016/j.breast.2025.104468Self-reported cognitive function in older breast cancer survivors after chemotherapy treatmentRachel Kim0Julia Peña1Kai-Ping Liao2Susan K. Peterson3Liang Li4Daria Zorzi5Holly M. Holmes6Mariana Chavez-MacGregor7Sharon H. Giordano8Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USADepartment of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USADepartment of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USADepartment of Behavioral Science, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, USADepartment of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USADepartment of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USADivision of Geriatric and Palliative Medicine, Department of Internal Medicine, University of Texas Houston McGovern Medical School, Houston, TX, USADepartment of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USADepartment of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Corresponding author. Departments of Health Services Research and Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Unit 1444, Houston, TX, 77030, USA.Purpose: This study evaluated self-reported cognitive function in older breast cancer survivors and its association with prior chemotherapy. Materials and methods: Breast cancer survivors aged 65-years and older, diagnosed 2012–2013, with local and regional stage disease, were identified through the linked Texas Cancer Registry-Medicare dataset. Survivors completed the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-CogV3) instrument and provided demographic and clinical data. A PCI--sub-score of less than 54 was used to identify cognitive impairment. Linear regression models were used to examine the FACT-CogV3 primary score, and logistic regression models evaluated the PCI--sub-score. Results: Of 4448 eligible survivors, 1594 (35.8 %) completed the FACT-Cog and 1065 completed all questions. The median time from diagnosis to survey completion was 68 months The median age at survey completion was 76 years. 26 % of patients had received adjuvant chemotherapy. In adjusted models, decreased FACT-Cog primary scores were associated with age 80-years and older (p<0.01 vs. age 65–69) and with depression (p < 0.01), and increased scores were associated with an education of 4-year college and above (p = 0.01).For the PCI-subscale, 243 patients (27.9 %) reported PCI-score <54. In the adjusted models, patients who were older than 80-years were more likely to report perceived cognitive impairment (OR 3.03, vs age 65–69), as well as those with depression (OR 6.19, p < 0.01). Prior chemotherapy was not a significant predictor of PCI (OR 1.49, p = 0.06). Conclusion: Adjuvant chemotherapy was not significantly associated with self-reported cognitive impairment in older breast cancer survivors 5–6 years after diagnosis.http://www.sciencedirect.com/science/article/pii/S0960977625004850Geriatric oncologyHealth outcomesBreast cancer survivorChemotherapy treatmentCognitive impairmentSurvey linked-data
spellingShingle Rachel Kim
Julia Peña
Kai-Ping Liao
Susan K. Peterson
Liang Li
Daria Zorzi
Holly M. Holmes
Mariana Chavez-MacGregor
Sharon H. Giordano
Self-reported cognitive function in older breast cancer survivors after chemotherapy treatment
Breast
Geriatric oncology
Health outcomes
Breast cancer survivor
Chemotherapy treatment
Cognitive impairment
Survey linked-data
title Self-reported cognitive function in older breast cancer survivors after chemotherapy treatment
title_full Self-reported cognitive function in older breast cancer survivors after chemotherapy treatment
title_fullStr Self-reported cognitive function in older breast cancer survivors after chemotherapy treatment
title_full_unstemmed Self-reported cognitive function in older breast cancer survivors after chemotherapy treatment
title_short Self-reported cognitive function in older breast cancer survivors after chemotherapy treatment
title_sort self reported cognitive function in older breast cancer survivors after chemotherapy treatment
topic Geriatric oncology
Health outcomes
Breast cancer survivor
Chemotherapy treatment
Cognitive impairment
Survey linked-data
url http://www.sciencedirect.com/science/article/pii/S0960977625004850
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