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Page 4 of 18 Borniger. J Cancer Metastasis Treat 2019;5:23 I http://dx.doi.org/10.20517/2394-4722.2018.107

Cognitive 321 patients admitted to the Mini-Mental State Examination 142 pts (44%) had abnormal MMSE [125]
Impairment Edmonton General Palliative (MMSE) was used as screening scores (MMSE < 0.8) on admission,
Care Unit over a period of tool to assess cognitive whereas 176 patients (55%) had abnormal
26 months functioning and was performed MMSE scores at the time of death or
on all patients at the time of discharge; 157 (68%) had abnormal MMSE
admission and once to twice scores prior to death; Of 124 patients with
weekly thereafter normal final MMSE scores, 64 (52%) were
discharged versus 16 of 116 patients (14%)
who had abnormal MMSE final scores (P <
0.0001)
Meta-analysis of 23 studies Articles published 1980- 8/24 included studies found a significant [126]
on cognitive impairment in 2012, comparing subjective relationship between objective and
cancer patients and objective cognition in subjective measures of cognitive
cancer patients treated with performance. These studies were more
chemotherapy. Of 818 potentially likely to involve breast cancer patients and
relevant articles, 23 studies met to assess the relationship between memory
the inclusion criteria for the and perceived cognitive impairment
current review and one article
was sourced from reference lists
of included studies
22 breast cancer survivors Qualitative interviews, recorded, 6 major domains identified: short-term [127]
who reported cognitive transcribed verbatim, and memory, long-term memory, speed of
impairment and who analyzed using a content analysis processing, attention and concentration,
were at least 1 year post- approach language and executive functioning;
chemotherapy treatment All survivors found these impairments
frustrating, and some also reported these
changes as detrimental to their self-
confidence and social relationships
85 women with early stage 3-year prospective study; No significant interactions or main effect [128]
breast cancer scheduled for neuropsychological performance of group after controlling for age and
chemotherapy, 43 women assessed at baseline (T1), post- intelligence; reliable decline on multiple
scheduled for endocrine chemotherapy (or 6 months) tasks was seen in 20% of chemotherapy
therapy and/or radiotherapy (T2) and at 18 months (T3) patients, 26% of nonchemotherapy
and 49 healthy control patients and 18% of controls at T2 (18%,
subjects 14 and 11%, respectively, at T3). Those
who experienced treatment-induced
menopause were more likely to show
decline on multiple measures at T2 (OR =
2.6, 95%CI 0.823-8.266 P = 0.086)
Metabolic 265 patients with advanced Retrospective study; mortality Overall survival was greater in diabetic [129]
Abnormalities breast cancer receiving was compared for diabetic and patients with proper metabolic control
palliative chemotherapy nondiabetic patients as well than diabetic patients with hyperglycemia.
as for patients that presented The risk of death was higher in patients
hyperglycemia during treatment with mean glucose levels > 130 mg/dL
during treatment
Meta-analysis of 20 studies RRs were calculated using a All 20 studies showed that women with [130]
(5 case-control and 15 random-effects model (vs. without) diabetes had a statistically
cohort studies) that reported significant 20% increased risk of breast
relative risk (RR) estimates cancer (RR, 1.20; 95%CI, 1.12-1.28). The
(odds ratio, rate ratio/ summary estimates were similar for case-
hazard ratio, or standardized control studies (RR, 1.18; 95%CI, 1.05-1.32)
incidence ratio) with 95%CI and cohort studies (RR, 1.20; 95%CI, 1.11-
for the relation between 1.30)
diabetes (largely Type II
diabetes) and breast cancer
incidence
Pooled individual-level Hazard ratios (HRs) of Inverse linear associations of BMI with [131]
data from 758,592 premenopausal breast cancer in breast cancer risk were found that were
premenopausal women from association with BMI from ages stronger for BMI at ages 18 to 24 years
2
19 prospective cohorts 18 through 54 years using Cox (HR per 5 kg/m [5.0-U] difference, 0.77;
proportional hazards regression 95%CI, 0.73-0.80) than for BMI at ages
analysis. Median follow-up; 9.3 45 to 54 years (HR per 5.0-U difference,
years (interquartile range, 4.9- 0.88; 95%CI, 0.86-0.91). 4.2-fold risk
13.5 years) per participant, with gradient between the highest and lowest
13,082 incident cases of breast BMI categories (BMI ≥ 35.0 vs. < 17.0)
cancer at ages 18 to 24 years (HR, 0.24; 95%CI,
0.14-0.40)
10,786 women ages 35- Blood samples were collected Adjusted relative risk (RR) for the highest [132]
69 were recruited in a after a 12-h fast between 7:30 quartile of serum glucose vs. the lowest
prospective study in Italy; and 9:00 a.m. was 2.8 (95%CI, 1.2-6.5), and P for
Four matched controls were trend was 0.02. Insulin showed a weaker
chosen for each breast association with breast cancer, the
cancer case (n = 144) adjusted RR of the highest quartile vs. the
lowest was 1.7 (95%CI, 0.7-4.1), and P
for trend was 0.14, whereas the adjusted
RR of the highest quartile of IGF-I was 3.1
(95%CI, 1.1-8.6), and P for trend was 0.01