Post-treatment Neurocognition and Psychosocial Care Among Breast Cancer Survivors

Buchanan, Natasha; Dasari, Sabitha; Rodriguez, Juan L.; Smith, Judith Lee; Hodgson, M. Elizabeth; Weinberg, Clarice R.; Sandler, Dale P.

doi:10.1016/j.amepre.2015.08.013

Cited by 49 publications

(51 citation statements)

References 30 publications

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“…Survey respondents included in the current study were women diagnosed with breast cancer who were enrolled in the Sister Study, a cohort of initially breast cancer-free women whose sister had been diagnosed with breast cancer. The design and inclusion criteria of the Sister Study have been described elsewhere [15]. This survey was approved by the Institutional Review Board of the NIEHS/NIH as an amendment to the protocol for the Sister Study.…”

Section: Methodsmentioning

confidence: 99%

Long-Term Satisfaction and Body Image After Contralateral Prophylactic Mastectomy

et al. 2017

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Background Contralateral prophylactic mastectomy (CPM) rates have been increasing in the U.S. Though some studies have reported high overall satisfaction among women who undergo CPM, it is unclear how long-term satisfaction differs from that of women who undergo unilateral mastectomy (UM). Furthermore, few studies have assessed whether the effects of CPM on body image differ from those of breast conserving surgery (BCS) or UM. Methods We analyzed responses from a survey of women with both a personal and family history of breast cancer who were enrolled in the Sister Study (n=1176). Among women who underwent mastectomy, satisfaction with mastectomy decision and reconstruction was compared between women who underwent CPM and UM. We also evaluated responses on 5 items related to body image according to surgery type (BCS, UM without reconstruction, CPM without reconstruction, UM with reconstruction, and CPM with reconstruction). Results Participants were, on average, 60.8 years old at diagnosis (SD=8.7) and 3.6 years post-diagnosis at the time of survey (SD=1.7). BCS was the most common surgical treatment reported (63%), followed by CPM (22%) and UM (15%). Satisfaction with mastectomy decision was reported by 97% of women who underwent CPM and 89% of those who underwent UM. Compared to other surgery types, women who underwent CPM without reconstruction reported feeling more self-conscious, less feminine, less whole, and less satisfied with the appearance of their breasts. Body image was consistently highest among women who underwent BCS. Conclusions In our sample of women with both a personal and family history of breast cancer, most were highly satisfied with their mastectomy decision, including those who elected to undergo CPM. However, body image was lowest among women who underwent CPM without reconstruction. Our findings may inform decisions among women considering various courses of surgical treatment.

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Section: Methodsmentioning

confidence: 99%

Long-Term Satisfaction and Body Image After Contralateral Prophylactic Mastectomy

et al. 2017

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“…Even if the prevalence of cognitive dysfunction in women with breast cancer is lower than anticipated, clinicians, researchers, and patients are still concerned about the long-term adverse effects of breast cancer treatment. For example, in a recent report on cognitive function for women with breast cancer, 60 % of female breast cancer survivors ( N = 2296) who were at least 1 year post-treatment self-reported cognitive problems after treatment (Buchanan et al 2015), highlighting the importance of research in this area. Other similar reports have consistently shown that cognitive dysfunction is one the “most feared” long-term sequela of cancer treatment (find this reference) (Myers 2012).…”

Section: Introductionmentioning

confidence: 99%

The relationship of cognitive performance to concurrent symptoms, cancer- and cancer-treatment-related variables in women with early-stage breast cancer: a 2-year longitudinal study

Lyon

Cohen

Chen

et al. 2016

J Cancer Res Clin Oncol

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Purpose Cognitive dysfunction in women with breast cancer continues to be an area of intense research interest. The prevalence, severity, timing, and cognitive domains that are most affected, as well as the contribution of cancer and its treatments to cognition, remain unresolved. Thus, longitudinal studies are needed that examine cognitive function during different stages of breast cancer treatment and survivorship. This longitudinal trial followed women with early-stage breast cancer, prior to chemotherapy through 2 years survivorship. Methods In women with early-stage breast cancer (N = −75), performance-based assessment of nine cognitive domains was performed at five time points beginning prior to chemotherapy and finishing 24 months after initial chemotherapy. Linear mixed effects models were used to examine the temporal changes in cognitive performance domains, while adjusting for cofactors, including those related to individuals, tumor attributes, chemotherapy (adjuvant or neoadjuvant), radiation, endocrine therapy, and concurrent symptoms. Results At baseline, scores on reaction time, complex attention, cognitive flexibility, executive function, and visual memory were lower than 90. At 2 years, all domains improved except for the memory domains (verbal, visual, and composite). Scores on six domains (psychomotor speed, reaction time, complex attention, cognitive flexibility, and visual memory) remained lower than 100 at 2 years. Neoadjuvant chemotherapy and fatigue had strong inverse relationship with cognitive functioning at multiple time points. Conclusion The low performance-based cognitive scores at baseline and over time warrant further study. Although most scores improved over time, memory did not improve. In all, the level of cognitive function is lower than expected for a majority college-educated sample. Thus, future studies are warranted to replicate these findings and to develop methods for identifying women with cognitive dysfunction pretreatment and into survivorship.

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“…Owing to growing concern among cancer patients about cognitive impairment [65, 56], it is important to comment on potentially efficacious interventions to ameliorate hormone therapy-induced cognitive impairment, even if somewhat premature. A recent review of the clinical and basic studies suggested that exercise may be beneficial for treating hormone therapy-induced cognitive impairments in women treated for breast cancer [66].…”

Section: Discussionmentioning

confidence: 99%

Cognitive impairment following hormone therapy: current opinion of research in breast and prostate cancer patients

Amidi

2017

Current Opinion in Supportive &Amp; Palliative Care

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Purpose of review Hormone therapy is a common cancer treatment that may be associated with numerous side and late effects, and in recent years, has been linked to changes in cognition. Here, we present the most important recent findings from empirical studies and reviews that have focused on the effects of hormone therapy on cognitive functioning in breast and prostate cancer populations, underline some general shortcomings, and propose directions for future research. Recent Findings Recent research indicates that cognitive impairment may occur in breast and prostate cancer patients following onset of hormone therapy. However, due to methodological shortcomings and heterogeneity of current research, conclusions regarding the effects of hormone therapy on cognitive functions remain tentative. Summary This review highlights the general findings whilst also describing the many methodological shortcomings that need to be addressed in future research. It is clear that larger scale neuropsychological studies that also evaluate the impact of impairments on daily life functioning will improve our understanding of the effects of hormone therapy on cognition and inform the development of appropriate interventions.

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Post-treatment Neurocognition and Psychosocial Care Among Breast Cancer Survivors

Cited by 49 publications

References 30 publications

Long-Term Satisfaction and Body Image After Contralateral Prophylactic Mastectomy

Long-Term Satisfaction and Body Image After Contralateral Prophylactic Mastectomy

The relationship of cognitive performance to concurrent symptoms, cancer- and cancer-treatment-related variables in women with early-stage breast cancer: a 2-year longitudinal study

Cognitive impairment following hormone therapy: current opinion of research in breast and prostate cancer patients

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