Perceived Cognitive Function and Related Factors in Korean Women With Breast Cancer

      This paper is only available as a PDF. To read, Please Download here.


      The aim of this study was to explore perceived cognitive function and its related factors in breast cancer patients that had received or were receiving adjuvant chemotherapy after surgery.


      A cross-sectional and correlational design was used in this study. A total of 118 women who had undergone or were undergoing adjuvant chemotherapy after breast cancer surgery recruited from a convenience sample from a university hospital in Korea were included in the study. The attentional function index was used to measure perceived cognitive function while the linear analogue self-assessment scale was used to measure mood disturbance. Hierarchical multiple regression analyses were done to determine possible predictors of perceived cognitive function in patients with breast cancer.


      Perceived cognitive function and mood disturbance had a mean score of 66.22 (SD= 13.43) and 159.78 (SD = 81.40), respectively. Mood disturbance was a statistically significant predictor of cognitive function in patients with breast cancer.


      Breast cancer patients with mood disturbance may experience decrements in perceived cognitive function. Nurses should be aware of mood changes and its influence on perceived cognitive function in breast cancer patients.

      Key Words


        • Ahles T.A.
        • Saykin A.J.
        Candidate mechanisms for chemotherapy-induced cognitive changes.
        Nature Reviews Cancer. 2007; 7: 192-201
        • Anderson-Hanley C.
        • Sherman M.L.
        • Riggs R.
        • Agocha V.B.
        • Compás B.E.
        Neuropsychological effects of treatments for adults with cancer: a meta-analysis and review of the literature.
        Journal of International Neuropsychological Society. 2003; 9: 967-982
        • Castellón S.A.
        • Ganz R.A.
        • Bower J.E.
        • Petersen L.
        • Abraham L.
        • Greendale G.A.
        Neurocognitive performance in breast cancer survivors exposed to adjuvant chemotherapy and tamoxifen.
        Journal of Clinical and Experimental Neuropsychology. 2004; 26: 955-969
        • Cimprich B.
        Attentional fatigue following breast cancer surgery.
        Research in Nursing and Health. 1992; 15: 199-207
        • Cimprich B.
        Development of an intervention to restore attention in cancer patients.
        Cancer Nursing. 1993; 26: 83-92
        • Cimprich B.
        Premature symptom distress in women newly diagnosed with breast cancer.
        Cancer Nursing. 1999; 22: 185-194
        • Cimprich B.
        • So H.
        • Ronis D.L.
        • Trask C.
        Pre-treatment factors related to cognitive functioning in women newly diagnosed with breast cancer.
        Psycho-Oncology. 2005; 14: 70-78
        • Cimprich B.
        • Visovatti M.
        • Ronis D.L.
        The attentional function index-a self-report cognitive measure.
        Psycho-Oncology. 2011; 20: 194-202
        • Debess J.
        • Riis J.O.
        • Engebjerg M.C.
        • Ewertz M.
        Cognitive function after adjuvant treatment for early breast cancer: a population-based longitudinal study.
        Breast Cancer Research and Treatment. 2010; 121: 91-100
        • Deprez S.
        • Amant E.
        • Yigit R.
        • Porke K.
        • Verhoeven J.
        • Van den Stock I.
        • et al.
        Chemotherapy-induced structural changes in cerebral white matter and its correlation with impaired cognitive functioning in breast cancer patients.
        Human Brain Mapping. 2011; 32 (4802n B.)
        • Falleti M.G.
        • Sanfilippo A.
        • Maruff P.
        • Weih L.
        • Phillips K.A.
        The nature and severity of cognitive impairment associated with adjuvant chemotherapy in women with breast cancer: a meta-analysis of the current literature.
        Brain and Cognition. 2005; 59: 50-60
        • Health Insurance Review & Assessment Service
        Prevalence and hospital cost of breast cancer.
        • Hermelink K.
        • Untch M.
        • Lux M.P.
        • Kreienberg R.
        • Beck T.
        • Bauerfeind I.
        • et al.
        Cognitive function during neoadjuvant chemotherapy for breast cancer: results of a prospective, multicenter, longitudinal study.
        Cancer. 2007; 109: 1905-1913
        • Hermelink K.
        • Küchenhoff H.
        • Untch M.
        • Bauerfeind I.
        • Lux M.P.
        • Buhner M.
        • et al.
        Two different sides of'chemobrain': determinants and nondetermi-nants of self-perceived cognitive dysfunction in a prospective, randomized, multicenter study.
        Psycho-Oncology. 2010; 19: 1321-1328
        • Jansen C.E.
        • Cooper B.A.
        • Dood M.I.
        • Miaskowski C.A.
        A prospective longitudinal study of chemotherapy-induced cognitive changes in breast cancer patients.
        Supportive Care in Cancer. 2010;
        • Jansen C.E.
        • Miaskowski C.
        • Dodd M.
        • Dowling G.
        • Kramer J.
        A metaanalysis of studies of the effects of cancer chemotherapy on various domains of cognitive function.
        Cancer. 2005; 104: 2222-2233
        • Jenkins V.
        • Shilling V.
        • Fallowfield L.
        • Howell A.
        • Hutton S.
        Does hormone therapy for the treatment of breast cancer have a detrimental effect on memory and cognition? A pilot study.
        Psycho-Oncology. 2004; 13: 61-66
        • Jim H.S.
        • Donovan K.A.
        • Small B.I.
        • Andrykowski M.A.
        • Munster P.N.
        • Jacobsen P.B.
        Cognitive functioning in breast cancer survivors: a controlled comparison.
        Cancer. 2009; 115: 1776-1783
      1. Kim, S. H. (2006). Effects of an individualized exercise program on cancer-related fatigue, physical and cognitive function, and emotional status in patients with gastric cancer during chemotherapy. Unpublished doctoral dissertation, Yonsei University, Seoul, Korea.

        • Mehlsen M.
        • Pedersen A.D.
        • Jensen A.B.
        • Zachariae R.
        No indications of cognitive side-effects in a prospective study of breast cancer patients receiving adjuvant chemotherapy.
        Psycho-Oncology. 2009; 18: 248-257
        • Mehnert A.
        • Scherwath A.
        • Schirmer L.
        • Petersen G.
        • Schulz-Kindermann E.
        • Zander A.R.
        • et al.
        The association between neuropsychological impairment, self-perceived cognitive deficits, fatigue and health related quality of life in breast cancer survivors following standard adjuvant versus high-dose chemotherapy.
        Patient Education and Counseling. 2007; 66: 108-118
        • National Cancer Information Center
        Cancer Survival Rate (1993-2008).
        • Paganini-Hill A.
        • Clark L.J.
        Preliminary assessment of cognitive function in breast cancer patients treated with tamoxifen.
        Breast Cancer Research and Treatment. 2000; 64: 165-176
        • Quesnel C.
        • Savard J.
        • Ivers H.
        Cognitive impairments association with breast cancer treatments: results from a longitudinal study.
        Breast Cancer Research and Treatment. 2009; 116: 113-123
        • Silverman D.H.
        • Dy C.J.
        • Castellón S.A.
        • Lai J.
        • Pio B.S.
        • Abraham L.
        • et al.
        Altered frontocortical, cerebella, and basal ganglia activity in adjuvant-treated breast cancer survivors 5-10 years after chemotherapy.
        Breast Cancer Research and Treatment. 2007; 103: 303-311
        • Stewart A.
        • Bielajew C.
        • Collins B.
        • Parkinson M.
        • Tomiak E.
        A meta-analysis of the neuropsychological effects of adjuvant chemotherapy treatment in women treated for breast cancer.
        The Clinical Neuropsychologist. 2006; 20: 76-89
        • Sutherland H.J.
        • Walker R.
        • Till J.E.
        The development of a method for determining oncology patients' emotional distress using linear analogue scales.
        Cancer Nursing. 1988; 11: 303-308
        • van Dam F.S.
        • Schagen S.B.
        • Muller M.J.
        • Boogerd W.
        • vd Wall E.
        • Droogleever Fortuyn M.E.
        • et al.
        Impairment of cognitive function in women receiving adjuvant treatment for high-risk breast cancer: high dose versus standard-dose chemotherapy.
        Journal of National Cancer Institute. 1998; 90: 210-218
        • Vearncombe K.J.
        • Rolfe M.
        • Wright M.
        • Wright M.
        • Pachana N.A.
        • Andrew B.
        • et al.
        Predictors of cognitive decline after chemotherapy in breast cancer patients.
        Journal of the International Neuropsychologi-cal Society. 2009; 15: 951-962
        • Verstappen C.C.
        • Heimans J.J.
        • Hoekman K.
        • Postma T.J.
        Neurotoxic complications of chemotherapy in patients with cancer: clinical signs and optima management.
        Drugs. 2003; 63: 1549-1563
        • Wefel J.S.
        • Lenzi R.
        • Theriault R.L.
        • Davis R.N.
        • Meyers C.A.
        The cognitive sequelae of standard-dose adjuvant chemotherapy in women with breast carcinoma: results of a prospective, randomized, longitudinal trial.
        Cancer. 2004; 100: 2292-2299
        • Wefel J.S.
        • Vardy I.
        • Ahles T.
        • Schagen S.B.
        International cognition and cancer tast force recommendations to harmonise studies of cognitive function in patients with cancer.
        The Lancet Oncology. 2011;