Lange M, et al. - In this study including patients ≥ 65 years of age with newly diagnosed early-stage breast cancer (EBC) and healthy controls (age-, sex-, and education-matched), researchers assessed cognitive changes before to after adjuvant treatment. The Reliable Change Index for cognitive decline was used to account for cognitive impairment status. Development of cognitive impairment was observed after the end of adjuvant treatment in 31% of older adult patients without initial objective cognitive impairment. An accelerated cognitive decline was detected in 6% following adjuvant treatment. For patients who are likely to be at highest risk for cognitive decline after cancer treatments, the inclusion of initial cognitive functioning in the balance of benefits and harms of systemic therapy was recommended.