title: Elucidating pretreatment cognitive impairment in breast cancer patients: the impact of cancer-related post-traumatic stress.
abstract: BACKGROUND
  Pretreatment cognitive impairment in cancer patients is well established but unexplained. Similar cognitive compromise has been observed in post-traumatic stress disorder (PTSD) patients, and PTSD symptoms are a frequent concomitant of cancer diagnosis. We tested the hypothesis that pretreatment cognitive impairment is attributable to cancer-related post-traumatic stress.
  
  
  METHODS
  Women aged 65 years or younger who were diagnosed with breast cancer (case patients) or had undergone negative routine breast imaging (control patients) at one of six participating breast centers underwent traditional and computerized neuropsychological testing, clinician-administered diagnostic assessment of stress disorders, and self-report assessments of cognitive function and depression. To minimize confounding, case patients were evaluated prior to any local or systemic treatment. Cognitive indices of case patients, control patients, and normative samples were compared. The patients' risk of overall cognitive impairment was determined. Linear regression and a mediation model were used to test the study hypothesis. All statistical tests were two-sided.
  
  
  RESULTS
  The 166 case patients and 60 well-matched control patients showed near-identical deviations from population norms. Case patients scored worse than control patients on two of 20 cognitive indices (Go/Nogo commission errors, Go/Nogo omission errors). Self-reported cognitive problems were associated with Go/Nogo omission errors and more pronounced in case patients. Only PTSD symptoms (Beta = 0.27, P = .004) and age (Beta = 0.22, P = .04) statistically significantly predicted Go/Nogo errors. The effect of having cancer on Go/Nogo errors was mediated by PTSD symptoms. Case patients did not have an increased risk of overall cognitive impairment.
  
  
  CONCLUSIONS
  Prior to any treatment, breast cancer patients may show limited cognitive impairment that is apparently largely caused by cancer-related post-traumatic stress.
authors.affiliation: Breast Center, Department of Gynecology and Obstetrics (Campus Grosshadern), CCCLMU University Hospital of Munich, Munich, Germany (KHe, VV, JK, FN, SH, NH); Breast Center, Department of Gynecology and Obstetrics (Campus Innenstadt), CCCLMU University Hospital of Munich, Munich, Germany (RW, KHä); Department of Psychology, Division of Psychological Methods and Assessment, Ludwig Maximilian University of Munich, Munich, Germany (MBü); Department of Psychology, Division of Neuropsychology, Ludwig Maximilian University of Munich, Munich, Germany (KM); Institute for Clinical Radiology, CCCLMU University Hospital of Munich, Munich, Germany (DRD, SG); Breast Center, Department of Gynecology, Red Cross Hospital, Munich, Germany (MBr); Breast Center, Department of Gynecology and Obstetrics, Dritter Orden Hospital, Munich, Germany (FEvK); Breast Center, Department of Gynecology and Obstetrics, District Hospital of Ebersberg, Ebersberg, Germany (SH); Breast Center, Department of Gynecology and Obstetrics, Hospital of Landshut, Landshut, Germany (IB); Breast Center, Department of Gynecology and Obstetrics, Helios Amper Hospital Dachau, Dachau, Germany (GD); Department of Psychosomatic Medicine and Psychotherapy, Division of Psychosocial Oncology, Roman Herzog Comprehensive Cancer Center, Technical University of Munich, Munich, Germany (PH). kerstin.hermelink@med.uni-muenchen.de.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Hermelink
authors.affiliation: Breast Center, Department of Gynecology and Obstetrics (Campus Grosshadern), CCCLMU University Hospital of Munich, Munich, Germany (KHe, VV, JK, FN, SH, NH); Breast Center, Department of Gynecology and Obstetrics (Campus Innenstadt), CCCLMU University Hospital of Munich, Munich, Germany (RW, KHä); Department of Psychology, Division of Psychological Methods and Assessment, Ludwig Maximilian University of Munich, Munich, Germany (MBü); Department of Psychology, Division of Neuropsychology, Ludwig Maximilian University of Munich, Munich, Germany (KM); Institute for Clinical Radiology, CCCLMU University Hospital of Munich, Munich, Germany (DRD, SG); Breast Center, Department of Gynecology, Red Cross Hospital, Munich, Germany (MBr); Breast Center, Department of Gynecology and Obstetrics, Dritter Orden Hospital, Munich, Germany (FEvK); Breast Center, Department of Gynecology and Obstetrics, District Hospital of Ebersberg, Ebersberg, Germany (SH); Breast Center, Department of Gynecology and Obstetrics, Hospital of Landshut, Landshut, Germany (IB); Breast Center, Department of Gynecology and Obstetrics, Helios Amper Hospital Dachau, Dachau, Germany (GD); Department of Psychosomatic Medicine and Psychotherapy, Division of Psychosocial Oncology, Roman Herzog Comprehensive Cancer Center, Technical University of Munich, Munich, Germany (PH).
authors.forename: Varinka
authors.initials: V
authors.lastname: Voigt
authors.affiliation: Breast Center, Department of Gynecology and Obstetrics (Campus Grosshadern), CCCLMU University Hospital of Munich, Munich, Germany (KHe, VV, JK, FN, SH, NH); Breast Center, Department of Gynecology and Obstetrics (Campus Innenstadt), CCCLMU University Hospital of Munich, Munich, Germany (RW, KHä); Department of Psychology, Division of Psychological Methods and Assessment, Ludwig Maximilian University of Munich, Munich, Germany (MBü); Department of Psychology, Division of Neuropsychology, Ludwig Maximilian University of Munich, Munich, Germany (KM); Institute for Clinical Radiology, CCCLMU University Hospital of Munich, Munich, Germany (DRD, SG); Breast Center, Department of Gynecology, Red Cross Hospital, Munich, Germany (MBr); Breast Center, Department of Gynecology and Obstetrics, Dritter Orden Hospital, Munich, Germany (FEvK); Breast Center, Department of Gynecology and Obstetrics, District Hospital of Ebersberg, Ebersberg, Germany (SH); Breast Center, Department of Gynecology and Obstetrics, Hospital of Landshut, Landshut, Germany (IB); Breast Center, Department of Gynecology and Obstetrics, Helios Amper Hospital Dachau, Dachau, Germany (GD); Department of Psychosomatic Medicine and Psychotherapy, Division of Psychosocial Oncology, Roman Herzog Comprehensive Cancer Center, Technical University of Munich, Munich, Germany (PH).
authors.forename: Judith
authors.initials: J
authors.lastname: Kaste
authors.affiliation: Breast Center, Department of Gynecology and Obstetrics (Campus Grosshadern), CCCLMU University Hospital of Munich, Munich, Germany (KHe, VV, JK, FN, SH, NH); Breast Center, Department of Gynecology and Obstetrics (Campus Innenstadt), CCCLMU University Hospital of Munich, Munich, Germany (RW, KHä); Department of Psychology, Division of Psychological Methods and Assessment, Ludwig Maximilian University of Munich, Munich, Germany (MBü); Department of Psychology, Division of Neuropsychology, Ludwig Maximilian University of Munich, Munich, Germany (KM); Institute for Clinical Radiology, CCCLMU University Hospital of Munich, Munich, Germany (DRD, SG); Breast Center, Department of Gynecology, Red Cross Hospital, Munich, Germany (MBr); Breast Center, Department of Gynecology and Obstetrics, Dritter Orden Hospital, Munich, Germany (FEvK); Breast Center, Department of Gynecology and Obstetrics, District Hospital of Ebersberg, Ebersberg, Germany (SH); Breast Center, Department of Gynecology and Obstetrics, Hospital of Landshut, Landshut, Germany (IB); Breast Center, Department of Gynecology and Obstetrics, Helios Amper Hospital Dachau, Dachau, Germany (GD); Department of Psychosomatic Medicine and Psychotherapy, Division of Psychosocial Oncology, Roman Herzog Comprehensive Cancer Center, Technical University of Munich, Munich, Germany (PH).
authors.forename: Franziska
authors.initials: F
authors.lastname: Neufeld
authors.affiliation: Breast Center, Department of Gynecology and Obstetrics (Campus Grosshadern), CCCLMU University Hospital of Munich, Munich, Germany (KHe, VV, JK, FN, SH, NH); Breast Center, Department of Gynecology and Obstetrics (Campus Innenstadt), CCCLMU University Hospital of Munich, Munich, Germany (RW, KHä); Department of Psychology, Division of Psychological Methods and Assessment, Ludwig Maximilian University of Munich, Munich, Germany (MBü); Department of Psychology, Division of Neuropsychology, Ludwig Maximilian University of Munich, Munich, Germany (KM); Institute for Clinical Radiology, CCCLMU University Hospital of Munich, Munich, Germany (DRD, SG); Breast Center, Department of Gynecology, Red Cross Hospital, Munich, Germany (MBr); Breast Center, Department of Gynecology and Obstetrics, Dritter Orden Hospital, Munich, Germany (FEvK); Breast Center, Department of Gynecology and Obstetrics, District Hospital of Ebersberg, Ebersberg, Germany (SH); Breast Center, Department of Gynecology and Obstetrics, Hospital of Landshut, Landshut, Germany (IB); Breast Center, Department of Gynecology and Obstetrics, Helios Amper Hospital Dachau, Dachau, Germany (GD); Department of Psychosomatic Medicine and Psychotherapy, Division of Psychosocial Oncology, Roman Herzog Comprehensive Cancer Center, Technical University of Munich, Munich, Germany (PH).
authors.forename: Rachel
authors.initials: R
authors.lastname: Wuerstlein
authors.affiliation: Breast Center, Department of Gynecology and Obstetrics (Campus Grosshadern), CCCLMU University Hospital of Munich, Munich, Germany (KHe, VV, JK, FN, SH, NH); Breast Center, Department of Gynecology and Obstetrics (Campus Innenstadt), CCCLMU University Hospital of Munich, Munich, Germany (RW, KHä); Department of Psychology, Division of Psychological Methods and Assessment, Ludwig Maximilian University of Munich, Munich, Germany (MBü); Department of Psychology, Division of Neuropsychology, Ludwig Maximilian University of Munich, Munich, Germany (KM); Institute for Clinical Radiology, CCCLMU University Hospital of Munich, Munich, Germany (DRD, SG); Breast Center, Department of Gynecology, Red Cross Hospital, Munich, Germany (MBr); Breast Center, Department of Gynecology and Obstetrics, Dritter Orden Hospital, Munich, Germany (FEvK); Breast Center, Department of Gynecology and Obstetrics, District Hospital of Ebersberg, Ebersberg, Germany (SH); Breast Center, Department of Gynecology and Obstetrics, Hospital of Landshut, Landshut, Germany (IB); Breast Center, Department of Gynecology and Obstetrics, Helios Amper Hospital Dachau, Dachau, Germany (GD); Department of Psychosomatic Medicine and Psychotherapy, Division of Psychosocial Oncology, Roman Herzog Comprehensive Cancer Center, Technical University of Munich, Munich, Germany (PH).
authors.forename: Markus
authors.initials: M
authors.lastname: Bühner
authors.affiliation: Breast Center, Department of Gynecology and Obstetrics (Campus Grosshadern), CCCLMU University Hospital of Munich, Munich, Germany (KHe, VV, JK, FN, SH, NH); Breast Center, Department of Gynecology and Obstetrics (Campus Innenstadt), CCCLMU University Hospital of Munich, Munich, Germany (RW, KHä); Department of Psychology, Division of Psychological Methods and Assessment, Ludwig Maximilian University of Munich, Munich, Germany (MBü); Department of Psychology, Division of Neuropsychology, Ludwig Maximilian University of Munich, Munich, Germany (KM); Institute for Clinical Radiology, CCCLMU University Hospital of Munich, Munich, Germany (DRD, SG); Breast Center, Department of Gynecology, Red Cross Hospital, Munich, Germany (MBr); Breast Center, Department of Gynecology and Obstetrics, Dritter Orden Hospital, Munich, Germany (FEvK); Breast Center, Department of Gynecology and Obstetrics, District Hospital of Ebersberg, Ebersberg, Germany (SH); Breast Center, Department of Gynecology and Obstetrics, Hospital of Landshut, Landshut, Germany (IB); Breast Center, Department of Gynecology and Obstetrics, Helios Amper Hospital Dachau, Dachau, Germany (GD); Department of Psychosomatic Medicine and Psychotherapy, Division of Psychosocial Oncology, Roman Herzog Comprehensive Cancer Center, Technical University of Munich, Munich, Germany (PH).
authors.forename: Karin
authors.initials: K
authors.lastname: Münzel
authors.affiliation: Breast Center, Department of Gynecology and Obstetrics (Campus Grosshadern), CCCLMU University Hospital of Munich, Munich, Germany (KHe, VV, JK, FN, SH, NH); Breast Center, Department of Gynecology and Obstetrics (Campus Innenstadt), CCCLMU University Hospital of Munich, Munich, Germany (RW, KHä); Department of Psychology, Division of Psychological Methods and Assessment, Ludwig Maximilian University of Munich, Munich, Germany (MBü); Department of Psychology, Division of Neuropsychology, Ludwig Maximilian University of Munich, Munich, Germany (KM); Institute for Clinical Radiology, CCCLMU University Hospital of Munich, Munich, Germany (DRD, SG); Breast Center, Department of Gynecology, Red Cross Hospital, Munich, Germany (MBr); Breast Center, Department of Gynecology and Obstetrics, Dritter Orden Hospital, Munich, Germany (FEvK); Breast Center, Department of Gynecology and Obstetrics, District Hospital of Ebersberg, Ebersberg, Germany (SH); Breast Center, Department of Gynecology and Obstetrics, Hospital of Landshut, Landshut, Germany (IB); Breast Center, Department of Gynecology and Obstetrics, Helios Amper Hospital Dachau, Dachau, Germany (GD); Department of Psychosomatic Medicine and Psychotherapy, Division of Psychosocial Oncology, Roman Herzog Comprehensive Cancer Center, Technical University of Munich, Munich, Germany (PH).
authors.forename: Dorothea
authors.initials: D
authors.lastname: Rjosk-Dendorfer
authors.affiliation: Breast Center, Department of Gynecology and Obstetrics (Campus Grosshadern), CCCLMU University Hospital of Munich, Munich, Germany (KHe, VV, JK, FN, SH, NH); Breast Center, Department of Gynecology and Obstetrics (Campus Innenstadt), CCCLMU University Hospital of Munich, Munich, Germany (RW, KHä); Department of Psychology, Division of Psychological Methods and Assessment, Ludwig Maximilian University of Munich, Munich, Germany (MBü); Department of Psychology, Division of Neuropsychology, Ludwig Maximilian University of Munich, Munich, Germany (KM); Institute for Clinical Radiology, CCCLMU University Hospital of Munich, Munich, Germany (DRD, SG); Breast Center, Department of Gynecology, Red Cross Hospital, Munich, Germany (MBr); Breast Center, Department of Gynecology and Obstetrics, Dritter Orden Hospital, Munich, Germany (FEvK); Breast Center, Department of Gynecology and Obstetrics, District Hospital of Ebersberg, Ebersberg, Germany (SH); Breast Center, Department of Gynecology and Obstetrics, Hospital of Landshut, Landshut, Germany (IB); Breast Center, Department of Gynecology and Obstetrics, Helios Amper Hospital Dachau, Dachau, Germany (GD); Department of Psychosomatic Medicine and Psychotherapy, Division of Psychosocial Oncology, Roman Herzog Comprehensive Cancer Center, Technical University of Munich, Munich, Germany (PH).
authors.forename: Susanne
authors.initials: S
authors.lastname: Grandl
authors.affiliation: Breast Center, Department of Gynecology and Obstetrics (Campus Grosshadern), CCCLMU University Hospital of Munich, Munich, Germany (KHe, VV, JK, FN, SH, NH); Breast Center, Department of Gynecology and Obstetrics (Campus Innenstadt), CCCLMU University Hospital of Munich, Munich, Germany (RW, KHä); Department of Psychology, Division of Psychological Methods and Assessment, Ludwig Maximilian University of Munich, Munich, Germany (MBü); Department of Psychology, Division of Neuropsychology, Ludwig Maximilian University of Munich, Munich, Germany (KM); Institute for Clinical Radiology, CCCLMU University Hospital of Munich, Munich, Germany (DRD, SG); Breast Center, Department of Gynecology, Red Cross Hospital, Munich, Germany (MBr); Breast Center, Department of Gynecology and Obstetrics, Dritter Orden Hospital, Munich, Germany (FEvK); Breast Center, Department of Gynecology and Obstetrics, District Hospital of Ebersberg, Ebersberg, Germany (SH); Breast Center, Department of Gynecology and Obstetrics, Hospital of Landshut, Landshut, Germany (IB); Breast Center, Department of Gynecology and Obstetrics, Helios Amper Hospital Dachau, Dachau, Germany (GD); Department of Psychosomatic Medicine and Psychotherapy, Division of Psychosocial Oncology, Roman Herzog Comprehensive Cancer Center, Technical University of Munich, Munich, Germany (PH).
authors.forename: Michael
authors.initials: M
authors.lastname: Braun
authors.affiliation: Breast Center, Department of Gynecology and Obstetrics (Campus Grosshadern), CCCLMU University Hospital of Munich, Munich, Germany (KHe, VV, JK, FN, SH, NH); Breast Center, Department of Gynecology and Obstetrics (Campus Innenstadt), CCCLMU University Hospital of Munich, Munich, Germany (RW, KHä); Department of Psychology, Division of Psychological Methods and Assessment, Ludwig Maximilian University of Munich, Munich, Germany (MBü); Department of Psychology, Division of Neuropsychology, Ludwig Maximilian University of Munich, Munich, Germany (KM); Institute for Clinical Radiology, CCCLMU University Hospital of Munich, Munich, Germany (DRD, SG); Breast Center, Department of Gynecology, Red Cross Hospital, Munich, Germany (MBr); Breast Center, Department of Gynecology and Obstetrics, Dritter Orden Hospital, Munich, Germany (FEvK); Breast Center, Department of Gynecology and Obstetrics, District Hospital of Ebersberg, Ebersberg, Germany (SH); Breast Center, Department of Gynecology and Obstetrics, Hospital of Landshut, Landshut, Germany (IB); Breast Center, Department of Gynecology and Obstetrics, Helios Amper Hospital Dachau, Dachau, Germany (GD); Department of Psychosomatic Medicine and Psychotherapy, Division of Psychosocial Oncology, Roman Herzog Comprehensive Cancer Center, Technical University of Munich, Munich, Germany (PH).
authors.forename: Franz Edler
authors.initials: FE
authors.lastname: von Koch
authors.affiliation: Breast Center, Department of Gynecology and Obstetrics (Campus Grosshadern), CCCLMU University Hospital of Munich, Munich, Germany (KHe, VV, JK, FN, SH, NH); Breast Center, Department of Gynecology and Obstetrics (Campus Innenstadt), CCCLMU University Hospital of Munich, Munich, Germany (RW, KHä); Department of Psychology, Division of Psychological Methods and Assessment, Ludwig Maximilian University of Munich, Munich, Germany (MBü); Department of Psychology, Division of Neuropsychology, Ludwig Maximilian University of Munich, Munich, Germany (KM); Institute for Clinical Radiology, CCCLMU University Hospital of Munich, Munich, Germany (DRD, SG); Breast Center, Department of Gynecology, Red Cross Hospital, Munich, Germany (MBr); Breast Center, Department of Gynecology and Obstetrics, Dritter Orden Hospital, Munich, Germany (FEvK); Breast Center, Department of Gynecology and Obstetrics, District Hospital of Ebersberg, Ebersberg, Germany (SH); Breast Center, Department of Gynecology and Obstetrics, Hospital of Landshut, Landshut, Germany (IB); Breast Center, Department of Gynecology and Obstetrics, Helios Amper Hospital Dachau, Dachau, Germany (GD); Department of Psychosomatic Medicine and Psychotherapy, Division of Psychosocial Oncology, Roman Herzog Comprehensive Cancer Center, Technical University of Munich, Munich, Germany (PH).
authors.forename: Kristin
authors.initials: K
authors.lastname: Härtl
authors.affiliation: Breast Center, Department of Gynecology and Obstetrics (Campus Grosshadern), CCCLMU University Hospital of Munich, Munich, Germany (KHe, VV, JK, FN, SH, NH); Breast Center, Department of Gynecology and Obstetrics (Campus Innenstadt), CCCLMU University Hospital of Munich, Munich, Germany (RW, KHä); Department of Psychology, Division of Psychological Methods and Assessment, Ludwig Maximilian University of Munich, Munich, Germany (MBü); Department of Psychology, Division of Neuropsychology, Ludwig Maximilian University of Munich, Munich, Germany (KM); Institute for Clinical Radiology, CCCLMU University Hospital of Munich, Munich, Germany (DRD, SG); Breast Center, Department of Gynecology, Red Cross Hospital, Munich, Germany (MBr); Breast Center, Department of Gynecology and Obstetrics, Dritter Orden Hospital, Munich, Germany (FEvK); Breast Center, Department of Gynecology and Obstetrics, District Hospital of Ebersberg, Ebersberg, Germany (SH); Breast Center, Department of Gynecology and Obstetrics, Hospital of Landshut, Landshut, Germany (IB); Breast Center, Department of Gynecology and Obstetrics, Helios Amper Hospital Dachau, Dachau, Germany (GD); Department of Psychosomatic Medicine and Psychotherapy, Division of Psychosocial Oncology, Roman Herzog Comprehensive Cancer Center, Technical University of Munich, Munich, Germany (PH).
authors.forename: Stephan
authors.initials: S
authors.lastname: Hasmüller
authors.affiliation: Breast Center, Department of Gynecology and Obstetrics (Campus Grosshadern), CCCLMU University Hospital of Munich, Munich, Germany (KHe, VV, JK, FN, SH, NH); Breast Center, Department of Gynecology and Obstetrics (Campus Innenstadt), CCCLMU University Hospital of Munich, Munich, Germany (RW, KHä); Department of Psychology, Division of Psychological Methods and Assessment, Ludwig Maximilian University of Munich, Munich, Germany (MBü); Department of Psychology, Division of Neuropsychology, Ludwig Maximilian University of Munich, Munich, Germany (KM); Institute for Clinical Radiology, CCCLMU University Hospital of Munich, Munich, Germany (DRD, SG); Breast Center, Department of Gynecology, Red Cross Hospital, Munich, Germany (MBr); Breast Center, Department of Gynecology and Obstetrics, Dritter Orden Hospital, Munich, Germany (FEvK); Breast Center, Department of Gynecology and Obstetrics, District Hospital of Ebersberg, Ebersberg, Germany (SH); Breast Center, Department of Gynecology and Obstetrics, Hospital of Landshut, Landshut, Germany (IB); Breast Center, Department of Gynecology and Obstetrics, Helios Amper Hospital Dachau, Dachau, Germany (GD); Department of Psychosomatic Medicine and Psychotherapy, Division of Psychosocial Oncology, Roman Herzog Comprehensive Cancer Center, Technical University of Munich, Munich, Germany (PH).
authors.forename: Ingo
authors.initials: I
authors.lastname: Bauerfeind
authors.affiliation: Breast Center, Department of Gynecology and Obstetrics (Campus Grosshadern), CCCLMU University Hospital of Munich, Munich, Germany (KHe, VV, JK, FN, SH, NH); Breast Center, Department of Gynecology and Obstetrics (Campus Innenstadt), CCCLMU University Hospital of Munich, Munich, Germany (RW, KHä); Department of Psychology, Division of Psychological Methods and Assessment, Ludwig Maximilian University of Munich, Munich, Germany (MBü); Department of Psychology, Division of Neuropsychology, Ludwig Maximilian University of Munich, Munich, Germany (KM); Institute for Clinical Radiology, CCCLMU University Hospital of Munich, Munich, Germany (DRD, SG); Breast Center, Department of Gynecology, Red Cross Hospital, Munich, Germany (MBr); Breast Center, Department of Gynecology and Obstetrics, Dritter Orden Hospital, Munich, Germany (FEvK); Breast Center, Department of Gynecology and Obstetrics, District Hospital of Ebersberg, Ebersberg, Germany (SH); Breast Center, Department of Gynecology and Obstetrics, Hospital of Landshut, Landshut, Germany (IB); Breast Center, Department of Gynecology and Obstetrics, Helios Amper Hospital Dachau, Dachau, Germany (GD); Department of Psychosomatic Medicine and Psychotherapy, Division of Psychosocial Oncology, Roman Herzog Comprehensive Cancer Center, Technical University of Munich, Munich, Germany (PH).
authors.forename: Gerlinde
authors.initials: G
authors.lastname: Debus
authors.affiliation: Breast Center, Department of Gynecology and Obstetrics (Campus Grosshadern), CCCLMU University Hospital of Munich, Munich, Germany (KHe, VV, JK, FN, SH, NH); Breast Center, Department of Gynecology and Obstetrics (Campus Innenstadt), CCCLMU University Hospital of Munich, Munich, Germany (RW, KHä); Department of Psychology, Division of Psychological Methods and Assessment, Ludwig Maximilian University of Munich, Munich, Germany (MBü); Department of Psychology, Division of Neuropsychology, Ludwig Maximilian University of Munich, Munich, Germany (KM); Institute for Clinical Radiology, CCCLMU University Hospital of Munich, Munich, Germany (DRD, SG); Breast Center, Department of Gynecology, Red Cross Hospital, Munich, Germany (MBr); Breast Center, Department of Gynecology and Obstetrics, Dritter Orden Hospital, Munich, Germany (FEvK); Breast Center, Department of Gynecology and Obstetrics, District Hospital of Ebersberg, Ebersberg, Germany (SH); Breast Center, Department of Gynecology and Obstetrics, Hospital of Landshut, Landshut, Germany (IB); Breast Center, Department of Gynecology and Obstetrics, Helios Amper Hospital Dachau, Dachau, Germany (GD); Department of Psychosomatic Medicine and Psychotherapy, Division of Psychosocial Oncology, Roman Herzog Comprehensive Cancer Center, Technical University of Munich, Munich, Germany (PH).
authors.forename: Peter
authors.initials: P
authors.lastname: Herschbach
authors.affiliation: Breast Center, Department of Gynecology and Obstetrics (Campus Grosshadern), CCCLMU University Hospital of Munich, Munich, Germany (KHe, VV, JK, FN, SH, NH); Breast Center, Department of Gynecology and Obstetrics (Campus Innenstadt), CCCLMU University Hospital of Munich, Munich, Germany (RW, KHä); Department of Psychology, Division of Psychological Methods and Assessment, Ludwig Maximilian University of Munich, Munich, Germany (MBü); Department of Psychology, Division of Neuropsychology, Ludwig Maximilian University of Munich, Munich, Germany (KM); Institute for Clinical Radiology, CCCLMU University Hospital of Munich, Munich, Germany (DRD, SG); Breast Center, Department of Gynecology, Red Cross Hospital, Munich, Germany (MBr); Breast Center, Department of Gynecology and Obstetrics, Dritter Orden Hospital, Munich, Germany (FEvK); Breast Center, Department of Gynecology and Obstetrics, District Hospital of Ebersberg, Ebersberg, Germany (SH); Breast Center, Department of Gynecology and Obstetrics, Hospital of Landshut, Landshut, Germany (IB); Breast Center, Department of Gynecology and Obstetrics, Helios Amper Hospital Dachau, Dachau, Germany (GD); Department of Psychosomatic Medicine and Psychotherapy, Division of Psychosocial Oncology, Roman Herzog Comprehensive Cancer Center, Technical University of Munich, Munich, Germany (PH).
authors.forename: Nadia
authors.initials: N
authors.lastname: Harbeck
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000523:psychology* / Q000628:therapy*; D016022:Case-Control Studies; D003071:Cognition; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000209:etiology*; D003863:Depression / Q000209:etiology; D005260:Female; D006801:Humans; D016014:Linear Models; D008875:Middle Aged; D009483:Neuropsychological Tests; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D057566:Self Report; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology; D013315:Stress, Psychological / Q000150:complications / Q000209:etiology*