Abstract
Breast cancer survival rates have markedly improved. Consequently, survivorship issues have received increased attention. One common sequel of treatment is chemotherapy-induced cognitive impairment (CICI). CICI causes a range of impairments that can have a significant negative impact on quality of life. Knowledge of the prevalence of this condition is required to inform survivorship plans, and ensure adequate resource allocation and support is available for sufferers, hence a systematic review of prevalence data was performed. Medline, Scopus, CINAHL and PSYCHInfo were searched for eligible studies which included prevalence data on CICI, as ascertained though the use of self-report, or neuropsychological tests. Methodological quality of included studies was assessed. Findings were synthesised narratively, with meta-analyses being used to calculate pooled prevalence when impairment was assessed by neuropsychological tests. The review included 52 studies. Time-points considered ranged from the chemotherapy treatment period to greater than 10 years after treatment cessation. Summary prevalence figures (across time-points) using self-report, short cognitive screening tools and neuropsychological test batteries were 44%, 16% and 21–34% respectively (very low GRADE evidence). Synthesised findings demonstrate that 1 in 3 breast cancer survivors may have clinically significant cognitive impairment. Prevalence is higher when self-report based on patient experience is considered. This review highlights a number of study design issues that may have contributed to the low certainty rating of the evidence. Future studies should take a more consistent approach to the criteria used to assess impairment. Larger studies are urgently needed.
Highlights
Breast cancer survival rates have markedly improved
The number of women with breast cancer living beyond a diagnosis has grown significantly, and survivorship issues are receiving more attention, with a particular focus on quality of life issues
Cognitive impairment is commonly reported in breast cancer patients both during and after cessation of treatment, and is likely triggered by multiple factors, such as endocrine therapy, the cancer itself, stress, and the hormonal changes resulting from menopause, amongst others
Summary
Breast cancer survival rates have markedly improved. survivorship issues have received increased attention. Cognitive impairment is commonly reported in breast cancer patients both during and after cessation of treatment, and is likely triggered by multiple factors, such as endocrine therapy, the cancer itself, stress, and the hormonal changes resulting from menopause, amongst others. A commonly cited range from the narrative review of Janelsins et al 2014 suggests that 12–82% of women will experience impairment as a result of their treatment r egime[14] This variability may be attributable to a range of patient factors such as age15, IQ16, menopausal status[16], and education level[17]. In spite of the name, it has been shown that cognitive impairment is often present before chemotherapy treatment has commenced, potentially arising as a result of cancer itself[19,20] This may occur via direct effects of the tumour itself, as a result of associated co-morbidities, or due to psychological factors such as worry and fatigue[21]. Prevalence rates may be influenced by the method used to assess cognitive impairment, with the three common methods employed being neuropsychological testing[24], short cognitive screening tools[25,26] and self-report[14]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
