Neuropsychological functioning and quality of life during the first year after completing chemotherapy for breast cancer.

OBJECTIVE: Research has documented modest cognitive difficulties among women treated for breast cancer. The present study was designed to evaluate the effects of these subtle cognitive changes on quality of life after treatment. METHODS: Data are presented from women breast cancer patients who completed neuropsychological tests and questionnaires regarding quality of life 6 and 12 months post-chemotherapy (n's=39 and 33). Neuropsychological test scores were examined for evidence of cognitive difficulties at each time point; repeated measures ANOVAs were used to identify changes over time. Regression analyses assessed relationships of quality of life outcomes with cognitive functioning, social support seeking, and fatigue. RESULTS: Small percentages of participants (<20% across tests) evidenced deficits in delayed memory, processing speed, response inhibition, and verbal fluency (VF) at each time point. Reliable change index analyses suggested statistically reliable improvements in each cognitive domain for a modest portion of participants. Regressions revealed hesitation to seek social support and fatigue as the most consistent predictors of quality of life at 6 and 12 months post-chemotherapy. Cognitive complaints and VF difficulties were also significantly related to quality of life at 12 months. CONCLUSIONS: In addition to confirming the importance of fatigue and social support in quality of life, these data offer preliminary indications that weaker VF skills and self-reported cognitive complaints may be associated with poorer functional outcomes among cancer survivors. Further research is needed to validate these potential relationships, which suggest that cognitive difficulties among cancer survivors may warrant monitoring and possible intervention.

Cognitive and psychological factors associated with early posttreatment functional outcomes in breast cancer survivors.

Breast cancer survivors experience cognitive difficulties following chemotherapy, yet the effects of these deficits on functional outcomes have not been systematically evaluated. This study assessed the relationships between postchemotherapy cognitive difficulties and functional outcomes. Forty-six women with breast cancer were seen at 1-month postchemotherapy; data were collected on cognitive functioning, psychological variables, and physical symptoms. Wilcoxon signed-rank analyses revealed cognitive deficits in executive functioning and verbal fluency. Subsequent regression analyses demonstrated that poorer executive functioning was associated with decreased productivity, community involvement, and social role functioning. Poorer quality of life was predicted by depression and reluctance to seek social support, but not cognitive functioning. These findings indicate that executive functioning deficits are associated with important functional outcomes among breast cancer survivors 1-month postchemotherapy. Thus, treatment efforts should focus on addressing cognitive, as well as psychological and physical, issues among cancer survivors.