Self-reported cognitive problems in women receiving adjuvant therapy for breast cancer.

Self-reported cognitive problems are common among women receiving adjuvant therapy for breast cancer but are unrelated to actual cognitive impairment. To date, no studies have objectively measured impairment and asked patients to speak about the type and extent of problems they encounter. We report interview data from 142 breast cancer patients receiving adjuvant therapy. We aimed to identify the types of problems and the extent to which they interfered with everyday life. We investigated the relationship between self-reported and objective cognitive impairment, quality of life and psychological distress. The majority of participants reported problems with their memory (71% overall at 6 months, 60% at 18 months) and concentration (64% and 42%, respectively). This was unrelated to objective cognitive decline; rather, it was associated with psychological distress and quality of life. For the vast majority, the problems reported were everyday slips and lapses. The neuropsychological measures routinely used may lack the sensitivity to detect these subtle changes experienced by this group. In addition, the effects of mood on cognition may be more important in everyday life than in the highly structured neuropsychological test situation. Future research should focus on developing cognitive assessments that tap everyday functioning.