Cited by 43Cancer-related cognitive impairment studiesEstrogen and related hormone effectsMenopause: Health Impacts and Treatments

Is basic research providing answers if adjuvant anti-estrogen treatment of breast cancer can induce cognitive impairment?

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Buwalda, Bauke, Schagen, Sanne B.·2013·Life Sciences

Abstract

Adjuvant treatment of cancer by chemotherapy is associated with cognitive impairment in some cancer survivors. Breast cancer patients are frequently also receiving endocrine therapy with selective estrogen receptor modulators (SERMs) and/or aromatase inhibitors (AIs) to suppress the growth of estradiol sensitive breast tumors. Estrogens are well-known, however, to target brain areas involved in the regulation of cognitive behavior. In this review clinical and basic preclinical research is reviewed on the actions of estradiol, SERMs and AIs on brain and cognitive functioning to see if endocrine therapy potentially induces cognitive impairment and in that respect may contribute to the detrimental effects of chemotherapy on cognitive performance in breast cancer patients. Although many clinical studies may be underpowered to detect changes in cognitive function, current basic and clinical reports suggest that there is little evidence that AIs may have a lasting detrimental effect on cognitive performance in breast cancer patients. The clinical data on SERMs are not conclusive, but some studies do suggest that tamoxifen administration may form a risk for cognitive functioning particularly in older women. An explanation may come from basic preclinical research which indicates that tamoxifen often acts agonistic in the absence of estradiol but antagonistic in the presence of endogenous estradiol. It could be hypothesized that the negative effects of tamoxifen in older women is related to the so-called window of opportunity for estrogen. Administration of SERMs beyond this so-called window of opportunity may not be effective or might even have detrimental effects similar to estradiol.

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Crossref · 10.1016/j.lfs.2012.12.012

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Authors
Buwalda, B., & Schagen, S. B.
Affiliations
  • University of Groningen (NL)
  • The Netherlands Cancer Institute (NL)
Corresponding author
Buwalda, Bauke
Venue
Life Sciences
Publisher
Elsevier BV
Published
2013-10
Volume
93
Issue
17
Pages
581-588
ISSN
0024-3205 (ISSN-L)
OpenAlex
W2073372625
Cited by
43
References
160
Citations by year
2026: 1 · 2024: 5 · 2022: 6 · 2021: 1 · 2020: 1 · 2019: 1 · 2017: 8 · 2016: 4 · 2015: 7 · 2014: 6 · 2013: 3
FWCI
1.04
Type
journal article
Language
en
Open access
Licence
other-oa
Locations
  • Life Sciences (publishedVersion)
  • PubMed (publishedVersion)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, other-oa)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Estrogen and related hormone effects
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
Keywords
breast cancer, adjuvant endocrine therapy, cognitive impairment, aromatase inhibitors, selective estrogen receptor modulators, tamoxifen, estradiol, chemotherapy-induced cognitive impairment, window of opportunity, cognitive function
MeSH terms
Animals, Brain, Breast Neoplasms, Cognition Disorders, Estradiol, Humans, Neuronal Plasticity, Chemotherapy, Adjuvant, Neuroprotective Agents, Antineoplastic Agents, Hormonal, Selective Estrogen Receptor Modulators, Aromatase Inhibitors

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