Tan Shijun, Yang Jiawei, Guo Guiping, Hong Shicui, Guo Li, Situ Honglin
Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
Department of Mammary Disease, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China.
Ann Med. 2025 Dec;57(1):2529579. doi: 10.1080/07853890.2025.2529579. Epub 2025 Jul 16.
Cognitive problems are among the most common post-treatment symptoms experienced by breast cancer patients, raising concerns about their long-term cognitive health. This meta-analysis aims to clarify the relationship between cognitive decline in breast cancer survivors and the risk of developing dementia.
PubMed, Embase, and Cochrane Library were searched for cohort studies published from database inception to August 27, 2024, using medical subject headings (MeSH) and keywords. All statistical analyses were performed using Stata statistical software version 14.0. If > 0.1 and I ≤50%, a fixed-effects model was adopted. If I > 50%, a random-effects model was adopted. The funnel plot and Egger's test were used to evaluate publication bias.
The meta-analysis, comprising 9 studies and involving 887,678 individuals, revealed that breast cancer survivors did not exhibit an increased risk of all-cause dementia [RR = 0.997, 95%CI (0.965, 1.029); I=0.0%, = 0.386], Intriguingly, endocrine therapy [RR = 0.904, 95%CI (0.865, 0.946); I = 41.7%, = 0.161] and chemotherapy [RR = 0.754, 95%CI (0.604, 0.940); I = 0.0%, = 0.592] may even serve as potential protective factors against dementia in breast cancer survivors.
This meta-analysis indicates that breast cancer survivors do not face an elevated risk of all-cause dementia. Furthermore, treatments such as endocrine therapy and chemotherapy may have a protective effect against dementia. Further research is needed to explore the underlying mechanisms and confirm these findings.
认知问题是乳腺癌患者治疗后最常见的症状之一，引发了人们对其长期认知健康的担忧。本荟萃分析旨在阐明乳腺癌幸存者认知功能下降与患痴呆症风险之间的关系。
检索了PubMed、Embase和Cochrane图书馆，以查找从数据库建立到2024年8月27日发表的队列研究，使用医学主题词（MeSH）和关键词。所有统计分析均使用Stata统计软件14.0版进行。如果I²>0.1且I≤50%，则采用固定效应模型。如果I>50%，则采用随机效应模型。采用漏斗图和Egger检验评估发表偏倚。
该荟萃分析纳入了9项研究，涉及887,678名个体，结果显示乳腺癌幸存者患全因性痴呆的风险并未增加[风险比（RR）=0.997，95%置信区间（CI）（0.965，1.029）；I²=0.0%，P=0.386]。有趣的是，内分泌治疗[RR = 0.904，95%CI（0.865，0.946）；I² = 41.7%，P = 0.161]和化疗[RR = 0.754，95%CI（0.604，0.940）；I² = 0.0%，P = 0.592]甚至可能是乳腺癌幸存者预防痴呆症的潜在保护因素。
该荟萃分析表明，乳腺癌幸存者患全因性痴呆症的风险并未升高。此外，内分泌治疗和化疗等治疗方法可能对痴呆症具有保护作用。需要进一步研究以探索其潜在机制并证实这些发现。
