Kathleen Van Dyk, PhD
Endocrine therapy (ET), commonly used for lengthy periods in the adjuvant treatment of patients with breast cancer, does not have a detrimental effect on cognitive function in survivors of early-stage disease, according to a study from the University of California Los Angeles (UCLA). Because ET is known to interfere with the action of estrogen in the body and brain, and several studies have previously linked cognitive decline to ET, Van Dyk et al undertook the Mind Body Study (MBS) to investigate a possible link between ET and cognitive impairment.
Figure 1. Mind Body Study Patient Population
): “The current study was powered and designed for broader questions than these, when there was scarce evidence in this area. Thus, future nuanced investigations are needed to better rule out or isolate medication effects and to determine whether we are missing vulnerable subgroups.”
Figure 2. Neurological Test Battery
Attrition among participants was high, and investigators noted that prior studies of the cognitive effects of ET have shown that attrition is higher among cognitively vulnerable populations, which also may have affected results. Among patients who received ET, 74 participated at the 3- to 6-year follow-up versus 28 in the no-ET group. This represented respective declines of 41.2% and 55.6%.
Figure 3. Baseline Characteristics of Study Sample (N = 189)
Nevertheless, the study was an important step in evaluating the longterm effects of a commonly prescribed treatment for this patient population. “Women are often recommended to stay on [ET] for 5 to 10 years, so risk to cognitive health can be a big concern,” lead author Kathleen Van Dyk, PhD, a neuropsychologist at the Semel Institute of Neuroscience and Human Behavior and the UCLA Jonsson Comprehensive Cancer Center, said in a statement.
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