Subjective cognitive complaints one year after ceasing adjuvant endocrine treatment for early-stage breast cancer

Br J Cancer. 2012 May 8;106(10):1618-25. doi: 10.1038/bjc.2012.156. Epub 2012 Apr 24.


Background: In the BIG 1-98 trial objective cognitive function improved in postmenopausal women 1 year after cessation of adjuvant endocrine therapy for breast cancer. This report evaluates changes in subjective cognitive function (SCF).

Methods: One hundred postmenopausal women, randomised to receive 5 years of adjuvant tamoxifen, letrozole, or a sequence of the two, completed self-reported measures on SCF, psychological distress, fatigue, and quality of life during the fifth year of trial treatment (year 5) and 1 year after treatment completion (year 6). Changes between years 5 and 6 were evaluated using the Wilcoxon signed-rank test. Subjective cognitive function and its correlates were explored.

Results: Subjective cognitive function and the other patient-reported outcomes did not change significantly after cessation of endocrine therapy with the exception of improvement for hot flushes (P=0.0005). No difference in changes was found between women taking tamoxifen or letrozole. Subjective cognitive function was the only psychosocial outcome with a substantial correlation between year 5 and 6 (Spearman's R=0.80). Correlations between SCF and the other patient-reported outcomes were generally low.

Conclusion: Improved objective cognitive function but not SCF occur following cessation of adjuvant endocrine therapy in the BIG 1-98 trial. The substantial correlation of SCF scores over time may represent a stable attribute.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aromatase Inhibitors / adverse effects*
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / pathology
  • Breast Neoplasms / psychology
  • Cognition / drug effects*
  • Estrogen Antagonists / adverse effects*
  • Female
  • Humans
  • Letrozole
  • Neoplasm Staging
  • Nitriles / adverse effects*
  • Quality of Life
  • Tamoxifen / adverse effects*
  • Triazoles / adverse effects*


  • Aromatase Inhibitors
  • Estrogen Antagonists
  • Nitriles
  • Triazoles
  • Tamoxifen
  • Letrozole