Cognitive function and quality of life after surgery for early breast cancer in North Jutland, Denmark

Figures & data

Table I.  Overview of the study population.

	Breast cancer patients N (%)	Control group N (%)
Invited	196 (100)	531 (100)
Included	124 (63)	224 (42)
Excluded, reason:
Declined participation	47 (24)	284 (53)
Cognitive problems	1 (0.5)	4 (0.8)
Psychological problems	8 (4.1)	2 (0.4)
Other diseases	2 (1.0)	5 (0.9)
Previous cancer	0 (0.0)	10 (2.0)
Other	14 (7.1)	2 (0.4)
Age, years among excluded
Mean (range)	51.1 (23 – 59)	48.8 (29 – 59)

Table II.  Clinical characteristics of 124 breast cancer patients included.

	N, (%)
Surgery
Mastectomy	84 (68)
Lumpectomy	40 (32)
Tumour size, mm
0-19	63 (51)
20 +	61 (49)
Tumour histology
Ductal	100 (81)
Lobular	12 (9.7)
Other	12 (9.7)
Removed nodes
<10 Nodes	25 (20)
10+ Nodes	99 (80)
Nodal status
Positive	68 (55)
Negative	55 (44)
Unknown	1 (0.8)
Hormone Receptor status
Positive	94 (76)
Negative	29 (23)
Unknown	1 (0.8)

Table III.  Characteristics of breast cancer patients and controls without cancer.

Characteristic	Breast cancer patients N = 124, (%)		Control group N = 224, (%)		P * BC ν C
Age, years
Mean		49.6		48.2	0.10
Range		29–59		28–59
Marital status
Married/living with a partner		109 (88)		186 (83)	0.23
Living alone		15 (12)		38 (17)
Years in school
< = 9		22 (18)		47 ( 21)	0.12
> 9		96 ( 77)		174 ( 78)
Other		6 (4.8)		3 (1.3)
Education level
No education		10 (8.1)		29 (13)	0.20
< 3 years		60 (48)		103 (46)
3–4 years		36 (29)		74 (33)
> 4 years		11 (8.9)		8 (3.6)
Other		7 (5.7)		10 (4.0)
Age at menarche
<12 years		27 (22)		62 (28)	0.07
13–14 years		66 (53)		130 (58)
15+ years		22 (18)		25 (11)
Unknown		9 (7.3)		7 (3.1)
Menopausal status
Pre/perimenopausal		72 (58)		141 (63)	0.37
Postmenopausal		52 (42)		83 (37)
Oral contraceptive use
Never		19 (15)		27 (12)	0.46
< 5 years		35 (28)		59 (26)
5 −		26 (21)		47 (21)
10 −		19 (15)		33 (15)
15 +		23 (19)		53 (24)
Unknown		2 (1.6)		5 (2.2)
Hormone replacement therapy
Never		102 (82)		190 (85)	0.53
Ever		21 (17)		30 (13)
Unknown		1 (0.8)		4 (1.8)
Family history of breast cancer
Yes		37 (30)		47 (21)	0.09
No		85 (69)		176 (79)
Missing		2 (1.6)		1 (0.5)
Age at childbirth	N	Mean (SD)	N	Mean (SD)
1. child	111	25.5 (4.8)	203	25.3 (4.7)	0.68
2. child	95	29.4 (5.1)	165	28.5 (4.5)	0.16
3. child	28	31.3 (5.1)	59	31.1 (4.4)	0.86
4. child	4	32.4 (7.2)	6	31.4 (5.2)	0.82

*P-values for breast cancer patients versus controls using t-test or χ².

Table IV.  Neuropsychological test scores of the study population.

	Breast cancer patients (N = 124)		Control group (N = 224)
Cognitive function	Median (IQR)*	Z-score	Median (IQR)*	Z-score	P ** BC ν C
Test battery:
DART	30.0 (7.0)		30.0 (11)		0.4
Verbal learning total (45 words)	33.0 (7.0)	−0.004	34.0 (7.0)	0.000	0.8
Verbal learning delayed (15 words)	12.0 (2.5)	−0.210	13.0 (3.0)	0.000	0.07
Concept shifting test (seconds)	30.3 (10.0)	−0.070	29.6 (10.8)	0.000	0.7
Stroop colour word test (seconds)	39.2 (11.5)	−0.160	37.9 (10.3)	0.000	0.3
Letter digit coding (numbers)	36.0 (9.0)	−0.160	37.0 (8.0)	0.000	0.2

*(IQR) Interquartile Range. **P-values: breast cancer patients versus control group.

Table V.  Change in perceived cognitive function during four weeks preceding the assessment.

Perceived cognitive function	Breast cancer patients N = 124 (%)	Control group N = 224 (%)	P* BC v C
Memory
Impairment	52 (42)	22 (9.8)	<0.0001
No change	68 (55)	190 (85)
Improvement	4 (3.3)	12 (5.4)
Concentration
Impairment	62 (50)	24 (11)	<0.0001
No change	59 (48)	189 (84)
Improvement	3 (2.4)	11 (4.9)
Mental fatigue
Impairment	73 (60)	20 (8.9)	<0.0001
No change	47 (38)	192 (85.7)
Improvement	4 (3.2)	12 (5.4)
Vigour
Impairment	76 (61)	42 (19)	<0.0001
No change	36 (29)	155 (69)
Improvement	12 (9.7)	27 (12)

*P-values breast cancer patients versus control group.

Table VI.  Psychological characteristics measured by EORTC QLQ-C30, POMS, and General Perceived Self-efficacy.

Median (IQR)*	Breast cancer patients N = 124	Control group N = 224	P* BC v C
EORTC QLQ-C30
Role function	66.7 (50.0)	100.0 (0.0)	<0.0001
Emotional function	79.2 (25.0)	91.7 (25.0)	<0.0001
Cognitive function	100.0 (16.7)	100.0 (16.7)	0.07
Social function	100.0 (16.7)	100.0 (0.0)	<0.0001
Global health score	75.0 (20.8)	83.3 (25.0)	<0.0005
Fatigue score	33.3 (19.4)	13.9 (33.3)	<0.0001
Pain score	33.3 (16.6)	0.0 (33.3)	<0.0001
Appetite loss score	0.0 (33.3)	0.0 (0.0)	<0.001
POMS
Tension-anxiety	2.0 (8.0)	1.0 (−2.0)	<0.005
Depression	3.0 (7.0)	2.0 (4.0)	<0.0005
Vigour	16.0 (8.5)	19.0 (7.0)	<0.0005
Confusion	0.0 (0.0)	−1.0(1.0)	<0.0001
General Perceived Self-efficacy
	31.5 (7.5)	30.0 (7.0)	0.11

*(IQR): Interquartile Range. ** P-values: breast cancer patients versus control group.