title: The association between neuropsychological impairment, self-perceived cognitive deficits, fatigue and health related quality of life in breast cancer survivors following standard adjuvant versus high-dose chemotherapy.
abstract: OBJECTIVE
  The possible association between neuropsychological impairment, self-perceived cognitive deficits, fatigue and health related quality of life has been studied in high-risk breast cancer survivors 5 years following standard adjuvant (n=23) versus high-dose chemotherapy (n=24) and in early-stage breast cancer patients (n=29) (comparison group) following radiation therapy.
  
  
  METHODS
  A neuropsychological assessment covering attention, memory and executive functions was used together with the questionnaire for self-perceived deficits in attention (FEDA), the multidimensional fatigue inventory (MFI-20) and the EORTC-QLQ-C30.
  
  
  RESULTS
  Findings have shown that neuropsychological impairment is not directly associated with self-perceived cognitive deficits, fatigue and HRQOL. However, 46% of patients reported self-perceived cognitive deficits and 82% of the patients complained about cancer related fatigue. Except for reduced activity we did not find significant group differences, even though patients who received standard-dose chemotherapy had consistently higher levels of self-perceived cognitive deficits and fatigue, and the lowest HRQOL.
  
  
  CONCLUSIONS
  Results emphasize the need for psychosocial counseling and support during treatment phase and follow up care as well. Sensitive cancer-specific measures for the assessment of self-perceived cognitive deficits in different cognitive domains according to neuropsychological measurements are required.
  
  
  CONCLUSIONS
  The role of self-perceived cognitive deficits and fatigue should be considered in educational interventions and counseling. Specific rehabilitation measures should be developed, implemented and evaluated in order to meet the needs of these patients and to decrease the frequency of cognitive deficits following cancer treatment.
authors.affiliation: Institute of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistr. 52-S35, 20246 Hamburg, Germany. mehnert@uke.uni-hanburg.de
authors.forename: Anja
authors.initials: A
authors.lastname: Mehnert
authors.forename: Angela
authors.initials: A
authors.lastname: Scherwath
authors.forename: Lena
authors.initials: L
authors.lastname: Schirmer
authors.forename: Barbara
authors.initials: B
authors.lastname: Schleimer
authors.forename: Corinna
authors.initials: C
authors.lastname: Petersen
authors.forename: Frank
authors.initials: F
authors.lastname: Schulz-Kindermann
authors.forename: Axel R
authors.initials: AR
authors.lastname: Zander
authors.forename: Uwe
authors.initials: U
authors.lastname: Koch
mesh_terms: D000328:Adult; D000359:Aftercare; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000188:drug therapy / Q000523:psychology; D017024:Chemotherapy, Adjuvant; D003072:Cognition Disorders / Q000139:chemically induced* / Q000175:diagnosis / Q000517:prevention & control / Q000523:psychology; D005221:Fatigue / Q000139:chemically induced* / Q000175:diagnosis / Q000517:prevention & control / Q000523:psychology; D005260:Female; D005858:Germany; D006301:Health Services Needs and Demand; D006304:Health Status; D006801:Humans; D008408:Mastectomy; D008875:Middle Aged; D009483:Neuropsychological Tests; D015404:Nursing Methodology Research; D010353:Patient Education as Topic; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*