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. 2023 Jul-Aug;46(4):E208-E217.
doi: 10.1097/NCC.0000000000001114. Epub 2022 Apr 12.

Distinct Cognitive Function Profiles Are Associated With a Higher Presurgery Symptom Burden in Patients With Breast Cancer

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Distinct Cognitive Function Profiles Are Associated With a Higher Presurgery Symptom Burden in Patients With Breast Cancer

Yu-Yin Allemann-Su et al. Cancer Nurs. 2023 Jul-Aug.

Abstract

Background: Cancer-related cognitive impairment (CRCI) is a common symptom in patients with breast cancer. In our previous study of 397 women with breast cancer, we identified 3 groups of patients with distinct CRCI profiles (ie, high, moderate, and low-moderate attentional function). Compared with the other 2 classes, the low-moderate class was younger, had more comorbidities, and with lower functional status.

Objectives: In this study, we expand on this work and evaluate for differences among these latent classes in the severity of psychological (depression and anxiety) and physical (fatigue, decrements in energy, sleep disturbance, and pain) symptoms before surgery.

Methods: Cancer-related cognitive impairment was assessed using the Attentional Functional Index from before through 6 months after surgery. Lower Attentional Functional Index scores indicate higher levels of CRCI. Psychological and physical symptoms were assessed with valid instruments. Parametric and nonparametric tests were used to evaluate for differences in symptom severity scores among the latent classes.

Results: Approximately 60% of patients experienced CRCI (ie, moderate and low-moderate classes). Significant differences were found among the 3 classes in the severity of trait and state anxiety, depressive symptoms, fatigue, and sleep disturbance (ie, high < moderate < low-moderate). In addition, compared with the other 2 classes, the low-moderate class reported higher pain interference scores.

Conclusions: These findings suggest that women with clinically meaningful levels of persistent CRCI have a relatively high symptom burden before surgery.

Implications for practice: Clinicians need to routinely perform preoperative assessments of CRCI and associated symptoms and initiate therapeutic interventions.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure
Figure
Observed and estimated attentional function latent classes from before through 6 months after breast cancer surgery. Adapted from Merriman JD, Aouizerat BE, Cataldo JK, et al. Association between an interleukin 1 receptor, type 1 promoter polymorphism and self-reported attentional function in women with breast cancer. Cytokine 2014;65:192–201.

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References

    1. Bai L, Yu E. A narrative review of risk factors and interventions for cancer-related cognitive impairment. Ann Transl Med. 2021;9(1):72. - PMC - PubMed
    1. Lange M, Joly F, Vardy J, et al. Cancer-related cognitive impairment: an update on state of the art, detection, and management strategies in cancer survivors. Ann Oncol. 2019;30(12):1925–1940. - PMC - PubMed
    1. Dijkshoorn ABC, van Stralen HE, Sloots M, Schagen SB, Visser-Meily JMA, Schepers VPM. Prevalence of cognitive impairment and change in patients with breast cancer: a systematic review of longitudinal studies. Psychooncology. 2021;30(5):635–648. - PMC - PubMed
    1. Janelsins MC, Kesler SR, Ahles TA, Morrow GR. Prevalence, mechanisms, and management of cancer-related cognitive impairment. Int Rev Psychiatry. 2014;26(1):102–113. - PMC - PubMed
    1. Olson B, Marks DL. Pretreatment cancer-related cognitive impairment mechanisms and outlook. Cancer. 2019;11(5). - PMC - PubMed