Learning and memory performance in breast cancer survivors 2 to 6 years post-treatment: The role of encoding versus forgetting Journal Article


Authors: Root, J. C.; Andreotti, C.; Tsu, L.; Ellmore, T. M.; Ahles, T. A.
Article Title: Learning and memory performance in breast cancer survivors 2 to 6 years post-treatment: The role of encoding versus forgetting
Abstract: Our previous retrospective analysis of clinically referred breast cancer survivors' performance on learning and memory measures found a primary weakness in initial encoding of information into working memory with intact retention and recall of this same information at a delay. This suggests that survivors may misinterpret cognitive lapses as being due to forgetting when, in actuality, they were not able to properly encode this information at the time of initial exposure. Our objective in this study was to replicate and extend this pattern of performance to a research sample to increase the generalizability of this finding in a sample in which subjects were not clinically referred for cognitive issues. We contrasted learning and memory performance between breast cancer survivors on endocrine therapy 2 to 6 years post-treatment with age- and education-matched healthy controls. We then stratified lower- and higher-performing breast cancer survivors to examine specific patterns of learning and memory performance. Contrasts were generated for four aggregate visual and verbal memory variables from the California Verbal Learning Test-2 (CVLT-2) and the Brown Location Test (BLT): Single-trial Learning: Trial 1 performance, Multiple-trial Learning: Trial 5 performance, Delayed Recall: Long-delay Recall performance, and Memory Errors: False-positive errors. As predicted, breast cancer survivors' performance as a whole was significantly lower on Single-trial Learning than the healthy control group but exhibited no significant difference in Delayed Recall. In the secondary analysis contrasting lower- and higher-performing survivors on cognitive measures, the same pattern of lower Single-trial Learning performance was exhibited in both groups, with the additional finding of significantly weaker Multiple-trial Learning performance in the lower-performing breast cancer group and intact Delayed Recall performance in both groups. As with our earlier finding of weaker initial encoding with intact recall in a cohort of clinically referred breast cancer survivors, our results indicate this same profile in a research sample of breast cancer survivors. Further, when the breast cancer group was stratified by lower and higher performance, both groups exhibited significantly lower performance on initial encoding, with more pronounced encoding weakness in the lower-performing group. As in our previous research, survivors did not lose successfully encoded information over longer delays, either in the lower- or higher-performing group, again arguing against memory decay in survivors. The finding of weaker initial encoding of information together with intact delayed recall in survivors points to specific treatment interventions in rehabilitation of cognitive dysfunction. The finding of weaker initial encoding of information together with intact delayed recall in survivors points to specific treatment interventions in rehabilitation of cognitive dysfunction and is discussed.
Keywords: adjuvant chemotherapy; carcinoma; cognition; memory; attention; women; metaanalysis; standardization sample; cancer; edition cvlt-ii
Journal Title: Journal of Cancer Survivorship
Volume: 10
Issue: 3
ISSN: 1932-2259
Publisher: Springer  
Date Published: 2016-06-01
Start Page: 593
End Page: 599
Language: English
ACCESSION: WOS:000376032700017
DOI: 10.1007/s11764-015-0505-4
PROVIDER: wos
PMCID: PMC4864094
PUBMED: 26658913
Notes: Article -- Source: Wos
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  1. Tim A Ahles
    182 Ahles
  2. James Charles Root
    113 Root