The Effect of Aromatase Inhibition on the Cognitive Function of Older Patients With Breast Cancer

This study examined the association between aromatase inhibitor (AI) therapy and cognitive function in older patients with breast cancer and evaluated the effects of AI therapy on cerebral metabolic activity, using positron emission tomography (PET) scans of the brain. Although no worsening of cognition was seen among the patients receiving AI therapy, changes in cerebral metabolic activity were observed. To the authors' knowledge, this is the first study to use PET scans to evaluate cognition in older patients with breast cancer receiving AI therapy. Introduction: This study evaluated the association between aromatase inhibitor (AI) therapy and cognitive function (over a 6-month period) in a cohort of patients aged >= 60 years compared with an age-matched healthy control group, and it evaluated changes in regional cerebral metabolism as measured by positron emission tomography (PET) scans of the brain done in a subset of the patient cohort. Patients and Methods: Thirty-five patients (32 evaluable) and 35 healthy controls were recruited to this study. Patients with breast cancer completed a neuropsychological battery, self-reported memory questionnaire, and geriatric assessment before initiation of AI therapy and again 6 months later. Age-matched healthy control participants completed the same assessments at the same time points as the patient group. Results: No significant decline in cognitive function was seen among individuals receiving an AI from pretreatment to 6 months later compared with healthy controls. In the PET cohort over the same period, both standardized volume of interest and statistical parametric mapping analyses detected specific changes in metabolic activity between baseline and follow-up uniquely in the AI patients, most significantly in the medial temporal lobes. Conclusion: Although patients undergoing AI treatment had few changes in neuropsychological performance compared with healthy controls over a 6-month period, regionally specific changes in cerebral metabolic activity were identified during this interval in the patient group. Additional longitudinal follow-up is needed to understand the potential clinical implications of these findings. (C) 2014 Elsevier Inc. All rights reserved.