A Study Of Chemotherapy-related Cognitive Impairment And Depression In Breast Cancer Patients

Objective The study aimed to analyze the occurrence of depression in postoperative breast cancer patients who had received six cycle standard chemotherapy and to investigate the alteration of cognitive function such as memory, attention, executive function before and after chemotherapy and also further explore the relationship between depression and cognitive impairment in breast cancer patients after chemotherapy.Methods First, self-rating depression scale(SDS) was applied in sixty-eight postoperative breast cancer patients without depression at oncology and breast surgery from October 2013 to August 2014. Second, a neuropsychology battery was used to measure the cognitive function of the breast cancer patients before the start of chemotherapy and record the patients’ general information. Finally, self-rating depression scale and neuropsychology testing were again used to evaluate depression and cognitive function after chemotherapy. A battery of neuropsychological tests comprises mini-mental state examination(MMSE), verbal fluency test(VFT), auditory words learn test(AVLT), digit span test(DS) and trail making test(TMT). Sixty-three postoperative breast cancer patients completed all the questionnaires before and after chemotherapy. The Statistical Package for the Social Sciences(SPSS) version 16.0 was used for all statistical analyses. The patients’ general information were tested using descriptive statistical analysis. Independent sample t-test was used for testing the differences of cognitive function before and after chemotherapy.Results ① The Sixty-three breast cancer patients after chemotherapy performed significantly difference in MMSE(27.84±1.73 vs. 26.19±1.77,P=0.000)、digit span backward(4.40±1.02 vs. 3.60±0.99,P=0.000)、AVLT3(7.06±0.78 vs. 6.76±0.86,P=0.002)、AVLT4(3.41±0.99 vs. 2.73±0.99,P=0.000)、AVLT5(2.81±0.76 vs. 2.16±0.68,P=0.000)、AVLT6(9.19±1.11 vs. 8.22±1.16,P=0.000)、TMTA(52.25±1.68 vs. 53.54±1.89,P=0.000)、TMTB(98.94±1.89 vs. 105.16±2.03,P=0.000)and SDS(37.44±6.74 vs. 48.31±13.09,P<0.05).② The incidence of depression was 46.03%. As compared with non-depression group after chemotherapy,the correct numbers of MMSE、VFT、AVLT1、AVLT4~6、digit span backward and TMTB were lower in the depression group(P<0.05).③The score of SDS were negatively correlated with the scores of MMSE、VFT(fruit)、AVLT3、digit span、TMTB, and the difference was statistically significant(P<0.05).Conclusion ① There are changes in cognitive function of memory, attention and executive functions in postoperative breast cancer patients on chemotherapy. The rate of depression is high in breast cancer patients. ②There are total cognition, memory, attention, language and executive functions impairment in postoperative breast cancer patients with depression and the cognitive impairment is related with depression. The evidence suggested that depression maybe further aggravate chemotherapy induced cognitive impairment in postoperative breast cancer patients.