No decline in functional status or cognitive function during the first year after treatment initiation for early-stage breast cancer in women aged 75 years and older: a prospective observational matched cohort study

medRxiv

Abstract

Background: This study compared functional and cognitive trajectories in older women treated for early breast cancer with matched women without cancer. Methods: Data were derived from two Dutch cohorts: the CLIMB study (women aged 75 years and older with operable breast cancer) and the ISCOPE study (community-dwelling women aged 75 years and older without cancer). Breast cancer patients were matched 1:2 to controls on age and baseline functional or cognitive status. Functional status was assessed using the Groningen Activity Restriction Scale (GARS), and cognitive function using the Mini-Mental State Examination (MMSE). Longitudinal changes over 12 months were analyzed using both unadjusted and confounder-adjusted linear mixed models. Results: 168 breast cancer patients and 336 matched breast cancer-free controls were included with a mean age of 80 years. Most breast cancer patients had stage 0-I or II disease and received surgery and/or radiotherapy; 48% received adjuvant endocrine therapy, chemotherapy was rare (<1%). At baseline, both cohorts were comparable in age and functional or cognitive status, although there was a higher comorbidity burden in the control cohort. No significant differences in functional or cognitive decline were observed between the cohorts over 12 months. Conclusions: In older women, early breast cancer and its treatment did not lead to accelerated decline in functional status or cognitive function within the first year compared to matched older women without cancer. These findings suggest that, for relatively fit older patients, breast cancer treatment may not accelerate functional decline in the short term.

Authors 15

1. Willeke van der Plas-Krijgsman Aachen

   Leiden University Medical Center

   Affiliation as printed

   Leiden University Medical Center;

2. Jeanet W. Blom Aachen

   Leiden University Medical Center

   Affiliation as printed

   Leiden University Medical Center;

3. Marloes G.M. Derks

   University Medical Center Utrecht

   Affiliation as printed

   University Medical Center Utrecht;

4. Thijs van Dalen

   Diakonessenhuis hospital

   Affiliation as printed

   Diakonessenhuis, Utrecht;

5. Leander van Gerven

   Haga Hospital

   Affiliation as printed

   Haga Ziekenhuis, The Hague;

6. Onno R. Guicherit

   Medisch Centrum Haaglanden

   Affiliation as printed

   Haaglanden Medical Center, The Hague;

7. Titia E. Lans

   Admiraal De Ruyter Ziekenhuis

   Affiliation as printed

   Admiraal de Ruyterziekenhuis, Goes and Vlissingen;

8. E. Linthorst-Niers

   Groene Hart Ziekenhuis

   Affiliation as printed

   Groene Hart Ziekenhuis, Gouda;

9. Jos W.S. Merkus

   Haga Hospital

   Affiliation as printed

   Haga Ziekenhuis, The Hague;

10. Annelie J. E. Vulink

    Reinier de Graaf Hospital

    Affiliation as printed

    Reinier de Graaf Gasthuis, Delft;

11. Simon P. Mooijaart Aachen

    Leiden University Medical Center

    Affiliation as printed

    Leiden University Medical Center;

12. Nienke A. de Glas

    Helse Førde

    Affiliation as printed

    Helse Forde, Forde, Norway

13. Jacobijn Gussekloo Aachen

    Leiden University Medical Center

    Affiliation as printed

    Leiden University Medical Center;

14. Gerrit‐Jan Liefers Aachen

    Leiden University Medical Center

    Affiliation as printed

    Leiden University Medical Center;

15. Johanneke E.A. Portielje Aachen

    Leiden University Medical Center

    Affiliation as printed

    Leiden University Medical Center;