Quality of life, fatigue, and subjective cognitive functioning immediately and 6 months after adjuvant chemotherapy in breast cancer patients

Abstract

Background

The aim of this study was to examine quality of life (QoL), fatigue, and subjective cognitive functioning (SCF) after chemotherapy in breast cancer (BC) patients.

Methods

BC patients were recruited before chemotherapy (3 FEC+3 Tax, BC-Chemo) and compared with disease-specific controls (i.e., BC patients not receiving chemotherapy, BC-Controls) and healthy controls (HC) matched for age and education.

All participants completed questionnaires assessing QoL (using the Functional Assessment of Cancer Therapy – General Population), fatigue (using the Functional Assessment of Chronic Illness Therapy-Fatigue), and SCF (with the Cognitive Failure Questionnaire) at recruitment and 6 months later (i.e., one month after the end of chemotherapy). Follow-up data (1 year after recruitment) were available for BC-Chemo and HC only.

Difference scores were computed for each participant (i.e., score after 6 months/ 1 year minus score at baseline) and transformed when necessary so that negative scores would reflect decline over time (i.e., decreased QOL, increased fatigue, and increased cognitive complaints). These difference scores were analysed using independent t-tests (BC-Chemo vs BC-Controls on one hand, and BC-Chemo vs HC on the other hand).

Results

Eighteen BC- Chemo, 19 BC-Controls, and 20 HC completed the study (mean age = 49, 58, and 44 years, resp., p = 0.001, BC-Controls being significantly older).

Statistical analyses showed that, after chemotherapy, BC- Chemo patients showed significantly lower QoL, more fatigue, and declined SCF than both groups of controls (see Table 1).

However, 6 months later, no statistically significant differences were found between BC- Chemo and HC with respect to QoL and fatigue. Only SCF remained significantly lower in BC- Chemo. Conclusions

Shortly after chemotherapy (i.e., 6 months after baseline), breast cancer patients experienced diminished QoL and increased fatigue compared to both disease-specific and healthy controls, but these differences were no longer significant 6 months later. In contrast, group differences in SCF were significant at both timepoints, suggesting long-lasting cognitive decline for patients receiving chemotherapy.