Analysis of Neurocognitive Elements of Attention Following Chemotherapy Treatment

Breast cancer affects approximately 123 out of 100,000 women per year in the United States, with 207,090 new cases estimated each year (Altekruse et al., 2010). Adjuvant chemotherapy has become a staple of care to improve long-term outcomes for several types of breast cancers (de Boer, Taskila, Ojajärvi, van Dijk, & Verbeek, 2009). Because of advances in treatment, the overall 5-year survival rate for breast cancer patients is now estimated at 89% (Altekruse et al., 2010). With increased survival comes a greater concern for issues related to quality of life, including cognitive function. Unfortunately, cancer treatments may result in cognitive changes or impairment, with deficits ranging from minor to debilitating (Argyriou, Assimakopoulos, Iconomou, Giannakopoulou, & Kalofonos, 2011). The phenomenon of cognitive dysfunction following cancer treatment is often called “chemo-brain” by patients and in the media. Despite an increase in the number of published studies in recent years, many aspects of chemotherapy-related cognitive dysfunction remain poorly understood. The pattern of cognitive impairment and neurological damage (as seen on neuroimaging) is reflective of disruption of frontal subcortical networks (Meyers, 2008). Because attention and related constructs are of central importance in this so-called “subcortical profile,” it is important to have a thorough understanding of how these domains are impacted by chemotherapy. However, available literature is difficult to interpret, in part because of various methodological factors, including the use of singular or otherwise limited neuropsychological tests, inconsistent use of tests across studies, and variability in the conceptualization of domains believed to be affected by chemotherapy (such as attention and related constructs). Thus, conclusions regarding attentional impairment in women treated for breast cancer are limited, and its role in the clinical syndrome known as chemo-brain remains poorly understood.