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

BackgroundCancer-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.ObjectivesIn 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.MethodsCancer-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.ResultsApproximately 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.ConclusionsThese findings suggest that women with clinically meaningful levels of persistent CRCI have a relatively high symptom burden before surgery.Implications for PracticeClinicians need to routinely perform preoperative assessments of CRCI and associated symptoms and initiate therapeutic interventions.

Automated summary

In our previous study, we found three distinct groups of breast cancer patients with different profiles of cancer-related cognitive impairment (CRCI). In this study, we further evaluated the differences in psychological and physical symptoms among these groups before surgery and found that the low-moderate class had higher levels of pain interference.