Cognitive function, fatigue, and menopausal symptoms in breast cancer patients receiving adjuvant chemotherapy: evaluation with patient interview after formal assessment.
BACKGROUND
Women who receive adjuvant chemotherapy for breast cancer report fatigue, menopausal symptoms and cognitive problems. Here we compare assessment of these symptoms using self-report questionnaires and a researcher-administered screen of cognitive function with the experience of women as revealed in a semi-structured interview.


METHODS
Twenty-one women who were receiving adjuvant chemotherapy completed the Functional Assessment of Cancer Treatment-General (FACT-G) self-report questionnaire, and sub-scales for fatigue (FACT-F) and endocrine symptoms (FACT-ES). They were evaluated for cognitive dysfunction using the High Sensitivity Cognitive Screen (HSCS). They then completed a semi-structured interview, which explored the nature and severity of these symptoms and their impact on daily function.


RESULTS
All patients experienced fatigue and most had menopausal symptoms. There was reasonable correlation of findings in the interview with FACT-F and FACT-ES scores. The HSCS revealed fewer problems than were reported by patients, and correlated with patient experience only for the domain of memory. Most patients noted adverse changes in other cognitive domains, especially concentration, with substantial effects on every-day function.


CONCLUSIONS
Women receiving adjuvant chemotherapy for breast cancer have substantial problems with fatigue, menopausal symptoms and cognitive changes. Formal tests such as the HSCS may fail to adequately capture the perceived impact of symptoms.
Department of Hematology and Oncology, Princess Margaret Hospital and University of Toronto, Toronto, Canada.
Fiona P
FP
Downie
Helen G
HG
Mar Fan
Nadine
N
Houédé-Tchen
Qilong
Q
Yi
Ian F
IF
Tannock
D000203:Activities of Daily Living; D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000523:psychology; D016022:Case-Control Studies; D017024:Chemotherapy, Adjuvant; D003072:Cognition Disorders / Q000139:chemically induced* / Q000453:epidemiology; D005221:Fatigue / Q000139:chemically induced* / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007407:Interviews as Topic; D008593:Menopause / Q000187:drug effects*; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D011788:Quality of Life
D000970:Antineoplastic Agents