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Park, Bae, Jung, and Jung: Prevalence and Characteristics of Chemotherapy-related Cognitive Impairment in Patients with Breast Cancer
Original Article

Journal of Korean Academy of Nursing 2015; 45(1): 118-128.

Published online: 27 February 2015

DOI: https://doi.org/10.4040/jkan.2015.45.1.118

Prevalence and Characteristics of Chemotherapy-related Cognitive Impairment in Patients with Breast Cancer

Jin-Hee Park1, Sun Hyoung Bae2, Yong-Sik Jung3, Young-Mi Jung1

1College of Nursing, Ajou University, Suwon, Korea.

2Department of Nursing, College of Medicine, Dong-A University, Busan, Korea.

3Department of Surgery, School of Medicine, Ajou University, Suwon, Korea.

Address reprint requests to: Bae, Sun Hyoung. Department of Nursing, College of Medicine, Dong-A University, 32 Daesingongwon-ro, Seo-gu, Busan 602-714, Korea. Tel: +82-51-240-2877, Fax: +82-51-240-2920, shyoung@dau.ac.kr

Received 12 September 2014       Revised 7 October 2014       Accepted 13 January 2015

© 2015 Korean Society of Nursing Science

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0/) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

Abstract

Purpose

Evidence suggests that some patients with breast cancer experience cognitive difficulties following chemotherapy. This longitudinal study was done to examine the prevalence of cognitive impairment and trajectory of cognitive function over time in women with breast cancer, who received adjuvant chemotherapy.

Methods

Participants were 137 patients with breast cancer. They completed neuropsychological tests and the Functional Assessment of Cancer Therapy-Cognitive Function before adjuvant therapy (pretest), toward the end of adjuvant therapy (posttest), and 6 months after the completion of adjuvant therapy (follow-up test). Of the patients, 91 were treated with adjuvant chemotherapy and 46 patients who did not receive chemotherapy made up the comparison group. A reliable-change index and repeated-measure ANOVA were used for statistical analyses.

Results

At the posttest point, over 30% of patients showed complex cognitive impairment and reported greater difficulty in subjective cognitive function. At the follow-up test point, 22.0% of patients exhibited complex cognitive impairment and 30.8% of patients complained of subjective cognitive impairment. Repeated-measure ANOVA showed significant decreases after receiving chemotherapy followed by small improvements 6 months after the completion of chemotherapy in cognitive domains of change for attention and concentration, memory, executive function, and subjective cognitive function.

Conclusion

These results suggest that chemotherapy in patients with breast cancer may be associated with objective and subjective cognitive impairments. Further studies are needed to explore the potential risk factors and predictor of chemotherapy-related cognitive changes. Also nursing interventions for prevention and intervention of cognitive impairments should be developed and tested.

Keywords: Breast neoplasms, Adjuvant chemotherapy, Attention, Memory, Executive function

Figures and Tables

Table 1

Homogeneity Tests between Chemotherapy Group and Comparison Group (N =137)

jkan-45-118-i001

*Fishers exact test; †Body mass index classified according to World Health Organization Western Pacific Region, International Association for the Study of Obesity, & International Obesity Task Force (2000); CTx=Chemotherapy; DCIS=Ductal carcinoma in situ; HRTx=Hormone therapy; KRW=Korean Won; M=Mean; MRM=Modified radical mastectomy; PM=Partial mastectomy; RTx=Radiotherapy; SD=Standard deviation; TM=Total mastectomy.

Table 2

Prevalence of Chemotherapy-Related Cognitive Impairment in Chemotherapy Group (N =91)

jkan-45-118-i002
Table 3

Changes of Cognitive Function in Chemotherapy Group (N =91)

jkan-45-118-i003

CI=Confidence interval; CogOth=Comments from others; CogPCA=Perceived cognitive abilities; CogPCI=Perceived cognitive impairments; CogQOL=Impact on quality of life; FACT-Cog=Functional assessment of cancer therapy-cognitive function; K-COWAT=Korean Controlled Oral Word Association Test; M=Mean; MD=Mean difference; SD=Standard deviation; SE=Standard error; SVLT=Seoul Verbal Learning Test; TMT=Trail making test.

Notes

This work was supported by the National Research Foundation of Korea (KRF) funded by the Korea government (MEST) (2011-0012145).

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