Anthracycline chemotherapy, such as doxorubicin and daunorubicin, is not associated with lasting cognitive decline among breast cancer survivors, according to a secondary analysis published in JAMA Oncology.1

Although potential adverse effects of breast cancer and its treatment on cognitive decline have been widely described, the risks of specific chemotherapies remain unclear. A recent retrospective cross-section study demonstrated lower memory scores approximately 2 years after breast cancer survivors underwent anthracycline treatment than after other chemotherapies or chemotherapy.

However, an earlier report that evaluated cognitive decline in a large sample of patients immediately after primary treatment and adjuvant chemotherapy found no association between anthracycline treatment and cognitive complaints.

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Therefore, researchers at the University of California Los Angeles Semel Institute for Neuroscience and Human Behavior and Los Angeles Jonsson Comprehensive Cancer Center sought to determine the risk of lasting cognitive decline with anthracycline treatment.

For the study, they analyzed data from the Mind Body Study, which enrolled 192 breast cancer survivors who underwent baseline neuropsychological evaluations. Of those, 11% received chemotherapy only, 34% had radiotherapy only, and 41% underwent both.

Patients were classified as having received no chemotherapy, chemotherapy but not an anthracycline, or chemotherapy with an anthracycline.

Results showed no difference in cognitive function with respect to memory, processing speed, and executive function, between those women who received chemotherapy with or without an anthracycline and those who did not receive chemotherapy. Further, researchers found that cognitive function was comparable between the 3 groups up to 7 years following treatment.

There was also no association between anthracycline exposure and neuropsychological performance.


1. Van Dyk K, Petersen L, Ganz PA. Comparison of neurocognitive function after anthracycline-based chemotherapy vs nonanthracycline-based chemotherapy [published online ahead of print April 21, 2016]. JAMA Oncol. doi:10.1001/jamaoncol.2016.0350.