Cognitive Rehabilitation Programs for Survivors of Breast Cancer Treated With Chemotherapy: A Systematic Review

Abstract

Background: Chemotherapy-related cognitive impairment (CRCI) is a condition experienced by many survivors of breast cancer. At present, there are a limited number of rehabilitation programs tailored to improve the cognitive performance of these survivors. Purpose: This systematic review aims to evaluate the existing evidence-based cognitive rehabilitation programs designed for survivors of breast cancer with CRCI. Methods: Electronic databases, including PubMed and CINAHL Plus, were used to identify the relevant articles. The search was restricted to studies published in the English language from inception to March 2020. The methodological quality of the studies included here was examined using the Quality Criteria for Rating Studies of Cognitive Rehabilitation. Results: The search strategy identified 1557 studies, 10 of which met the inclusion criteria. The studies included randomized controlled trial (n = 6), quasi-randomized controlled trial (n = 1), and single-arm trial (n = 3). Discussion and Limitations: Seven of the 10 studies were considered high-quality cognitive rehabilitation research. Cognitive training (n = 4), compensatory strategies (n = 5), and a combination of cognitive training and compensatory strategies (n = 1) were shown to improve executive function, working and verbal memory, processing speed, and attention. Conclusion: Cognitive rehabilitation programs demonstrated positive outcomes for survivors of breast cancer with cognitive impairment. However, because of methodological concerns and the diversity in the programs' parameters and outcome measures, an explicit recommendation could not be established. The findings may guide future research, policies, and practices related to cognitive rehabilitation programs for survivors of breast cancer.