(ChemotherapyAdvisor) – More than 20 years after receiving adjuvant chemotherapy with cyclophosphamide, methotrexate, and fluorouracil (CMF), breast cancer survivors were found to perform worse on neuropsychological tests compared with random population controls, results of a study published in the Journal of Clinical Oncology online February 27 have reported.

The investigators found the pattern of cognitive problems to be largely similar to what is observed in patients shortly after chemotherapy cessation. The case-cohort study compared the cognitive performance of 196 patients with breast cancer who had a history of six cycles of adjuvant CMF chemotherapy with an average time since treatment of 21 years to 1,509 women who had never been diagnosed with cancer. Patients who had ever used adjuvant endocrine therapy, or had a secondary malignancy, recurrence, or metastasis were excluded from the study.

On cognitive tests of immediate and delayed verbal member, processing speed, executive function, and psychomotor speed, women exposed to CMF treatment performed significantly worse than the reference group. In addition, they had fewer symptoms of depression but significantly more memory complaints on two of three measures not explained by cognitive test performance, the investigators noted.

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“This study suggests that cognitive deficits following breast cancer diagnosis and subsequent CMF chemotherapy can be long lasting,” they concluded.