Authors (including presenting author) :
Cheung SWA(1), Chan NYR(1), NG PCA(1), Poon WFD(1)
Affiliation :
(1) Occupational Therapy Department, Prince of Wales Hospital
Introduction :
Chemotherapy is one of the most common treatments for breast cancer(BC). It is considered to be associated with cognitive impairment, commonly referred as chemotherapy-related cognitive impairment(CRCI) or “chemobrain”, undermining patients’ daily functioning and quality of life (QoL). Service gap was noted for specific management strategies to address the above challenge.
Objectives :
1.To investigate the prevalence of cognitive deficit among breast cancer survivors (BCS) and 2. to explore the feature of cognitive deficit among them.
Methodology :
This was a retrospective cross-sectional design. Under Breast Cancer Survivorship Program in Oncology Clinic of Prince of Wales Hospital, BC patients with memory or attention problems were referred to Occupational Therapy for “Cognitive Assessment and Rehabilitation”.
Objective and subjective cognitive function were evaluated using “Hong Kong Montreal Cognitive Assessment (HK-MoCA) and “Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) scale” respectively. A lower HK-MoCA score indicates worse cognitive function; a lower FACT-Cog score reflects a greater impact on QoL. Individualized interventions with a 6-month follow-up would be provided for those with HK-MoCA scores below cut-off.
Result & Outcome :
25 patients (mean age = 60.6± 9.3) were reviewed from January 2023 to December 2024. 44% of them received chemotherapy with a mean time of 5.3 years ago. The majority of patients were at stage 1 BC (44%).
Regarding cognitive function, the mean HK-MoCA score was 24.7 (± 4.3). 40% of them scored below the 16th percentile or the generic cut-off (26 marks for individuals under 65 years old), while 4% scored below the 7th percentile. The average scores were 22.8 and 26.1 respectively for patients who underwent chemotherapy and who did not. Declined executive function (Mean=4±1.1), working memory (Mean=2.5±0.7) and short-term memory (Mean=3.0±1.5) were observed. Regarding subjective cognitive performance, Perceived Cognitive Impairments (CogPCI) under FACT-Cog had a mean score of 38.6 (SD=12.7) out of 72, demonstrating an impact on QoL.
Among patients who have completed a course of cognitive training and a 6-month follow-up, the average HK-MoCA score improved from 22.1(±4.1) to 24.1(±3.4), and the average CogPCI score improved from 38.0(±12.1) to 43.1(±14.1), implying the potential for cognitive improvement.
In conclusion, cognitive decline is prevalent among breast cancer survivors who have received chemotherapy, particularly in short-term memory and QoL. Future studies and service planning are suggested to cater the training needs of the BCS at an early stage.
