Endocrine therapy is associated with low performance on some estrogen-sensitive cognitive tasks in postmenopausal women with breast cancer

Abstract

This study investigated the effects of endocrine therapy (i.e., tamoxifen and anastrozole) on cognitive functioning by comparing 28 postmenopausal women with breast cancer to 37 healthy age-equivalent controls. Participants completed neuropsychological tests previously shown to be estrogen sensitive (e.g., verbal memory, letter fluency). A significant treatment effect was observed on speeded measures of letter fluency, complex visuomotor attention, and manual dexterity, but not on measures of verbal or object-location memory, or on tests presumed to be estrogen insensitive (e.g., spatial ability). In partial support of previous research, these results indicate that endocrine therapy can have detrimental effects on speeded higher brain functions but not necessarily on memory.

Keywords:

• Endocrine therapy
• Cognition
• Tamoxifen
• Anastrozole
• Breast cancer
• Memory
• Hormones
• Verbal fluency
• Processing speed
• Cancer

Notes

¹Tamoxifen is a selective estrogen receptor modulator (SERM) that blocks the binding of estrogen to estrogen receptors, whereas anastrozole is an aromatase inhibitor (AI) that reduces the amount of circulating estrogen by preventing the conversion of androgen to estrogen.

²Chemotherapy independent of endocrine therapy use is associated with cognitive changes in women with breast cancer (Brezden, Phillips, Abdollel, Bunston, & Tannock, 2000; Tchen et al., 2003), whereas radiation is not (Bender, Paraska, Sereika, Ryan, & Berga, 2001; van Dam et al., 1998).