Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists · 2026
Prospective memory in breast cancer survivors treated with endocrine therapy: findings from an ecological virtual reality task.
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Duivon Mylène, Perrier Joy, Christy François, Grellard Jean-Michel, Clarisse Bénédicte, Joly Florence, Fernette Marie, Gernier François, Geffrelot Julien, Emile George, Lévy Christelle, Lecouvey Grégory, Viader Fausto, Eustache Francis, Giffard Bénédicte
Аннотация
OBJECTIVE: Cognitive effects of endocrine therapy (ET) in breast cancer are often subtle and may escape detection by standard neuropsychological assessments. Prospective memory (PM)-the ability to carry out intended actions-is particularly sensitive to mild cognitive changes, and crucial for autonomy and treatment adherence. This study examined the impact of ET, administered without chemotherapy, on PM using a virtual reality (VR)-based paradigm.
METHOD: Thirty-eight postmenopausal breast cancer survivors treated with ET (ET+) or without ET (ET-), and 21 healthy controls were evaluated. To isolate the cognitive effects of ET, none of the patients had received chemotherapy. Participants completed standardized neuropsychological tests, self-report questionnaires, and a VR-based PM task assessing recall of event-based (EB) and time-based (TB) intentions after short (10-min) and long (10 h) delays.
RESULTS: Despite preserved performance on standard neuropsychological measures, ET+ patients showed significantly lower PM performance than ET- patients, specifically for TB intentions after the short delay (p.adj = .002). The prospective component of these TB intentions was particularly less frequently retrieved (p.adj = .014), despite preserved storage.
CONCLUSIONS: This study provides preliminary evidence suggesting that ET, independent of chemotherapy-related neurotoxicity, may be associated with alterations in PM. The pattern of PM performance in ET+ patients suggests a disruption in self-initiated retrieval processes during early consolidation, when memory traces remain labile and vulnerable to interference. The use of an immersive VR-based PM paradigm revealed subtle cognitive changes not captured by conventional assessments, underscoring the clinical value of ecologically valid tools.
METHOD: Thirty-eight postmenopausal breast cancer survivors treated with ET (ET+) or without ET (ET-), and 21 healthy controls were evaluated. To isolate the cognitive effects of ET, none of the patients had received chemotherapy. Participants completed standardized neuropsychological tests, self-report questionnaires, and a VR-based PM task assessing recall of event-based (EB) and time-based (TB) intentions after short (10-min) and long (10 h) delays.
RESULTS: Despite preserved performance on standard neuropsychological measures, ET+ patients showed significantly lower PM performance than ET- patients, specifically for TB intentions after the short delay (p.adj = .002). The prospective component of these TB intentions was particularly less frequently retrieved (p.adj = .014), despite preserved storage.
CONCLUSIONS: This study provides preliminary evidence suggesting that ET, independent of chemotherapy-related neurotoxicity, may be associated with alterations in PM. The pattern of PM performance in ET+ patients suggests a disruption in self-initiated retrieval processes during early consolidation, when memory traces remain labile and vulnerable to interference. The use of an immersive VR-based PM paradigm revealed subtle cognitive changes not captured by conventional assessments, underscoring the clinical value of ecologically valid tools.