Cognitive and Psychological Factors Associated with Early Posttreatment Functional Outcomes in Breast Cancer Survivors

Abstract

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.

KEYWORDS:

• breast cancer
• cognitive
• quality of life
• social support
• community integration

This research was supported by Grant R03 CA108340 from the National Cancer Institute.

Notes

^a(Wechsler, 1997b).

^b(Taylor, 1959).

^c Reitan (1955).

^d(Wechsler, 1997a).

^e(Golden, 1978).

^f(Benton & Hamsher, 1989).

^g(Spreen & Strauss, 1991).

^a(difference) score = (Domain composite z-score)–(Wide Range Achievement Test-3 Reading z-score)

^bWilcoxon signed-rank test, p < .05.

^cWilcoxon signed-rank test, p < .001.

∗p < 0.05 (2-tailed).

∗∗p < 0.01 (2-tailed).