title: Cognitive Deficits in Breast Cancer Survivors After Chemotherapy and Hormonal Therapy.
abstract: Adjuvant treatments, specifically chemotherapy and hormonal therapy, have dramatically increased breast cancer survival, resulting in increased attention to the residual effects of treatment. Breast cancer survivors (BCS) frequently report that cognitive deficits are a particular source of distress, interfering with many aspects of quality of life. The literature on neuropsychological performance measures in BCS supports the reality of subtle cognitive deficits after both chemotherapy and hormonal therapy. This premise is supported by recent imaging studies, which reveal anatomical changes after chemotherapy as well as changes in patterns of neural activation while performing cognitive tasks. This review suggests that, even when performance on neuropsychological performance measures is within normal limits, BCS may be using increased cognitive resources in the face of reduced cognitive reserve. Potential interventions for cognitive deficits after adjuvant therapy include prescriptions for healthy living, pharmacotherapy, complementary therapy, and cognitive remediation therapy directed toward specific cognitive deficits or a combination of several strategies.
authors.affiliation: Questions or comments about this article may be directed to Jennifer Sandson Frank, PhD, at jfranf@uab.edu. She is an Instructor, School of Nursing, University of Alabama at Birmingham, Birmingham, AL. David E. Vance, PhD MGS, is Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, AL. Kristen L. Triebel, PsyD, is Assistant Professor, Department of Neurology, University of Alabama at Birmingham, Birmingham, AL. Karen M. Meneses, PhD RN FAAN, is Professor and Associate Dean for Research, School of Nursing, University of Alabama at Birmingham, Birmingham, AL.
authors.forename: Jennifer Sandson
authors.initials: JS
authors.lastname: Frank
authors.forename: David E
authors.initials: DE
authors.lastname: Vance
authors.forename: Kristen L
authors.initials: KL
authors.lastname: Triebel
authors.forename: Karen M
authors.initials: KM
authors.lastname: Meneses
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects*; D047072:Aromatase Inhibitors / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy*; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D003072:Cognition Disorders / Q000139:chemically induced* / Q000628:therapy; D005260:Female; D006801:Humans; D009483:Neuropsychological Tests; D011788:Quality of Life; D020845:Selective Estrogen Receptor Modulators / Q000009:adverse effects*; D017741:Survivors / Q000523:psychology*
chemical_list: D000970:Antineoplastic Agents; D047072:Aromatase Inhibitors; D020845:Selective Estrogen Receptor Modulators