Cognitive effects associated with returning to work after a breast cancer diagnosis
19 August 2024
2 minutes reading time
According to the results of a series of case studies, cognitive performance appeared to be associated with the likelihood of individuals returning to work two years after breast cancer diagnosis.
Previous studies have shown that at least half of breast cancer patients experience cognitive problems – such as problems with attention, memory or processing speed – after adjuvant chemotherapy, according to study results. Objective cognitive decline is observed in up to a quarter of patients.
According to one study, 76% of patients with cognitive symptoms reported difficulties returning to work. Associated challenges included difficulty remembering or concentrating, reduced performance, and problems performing or planning their work.
However, no longitudinal studies have been conducted to examine the association between cancer-related cognitive impairment and return to work.
Marie Lange, PhD, of the Department of Clinical Research at the Centre François Baclesse in France and colleagues conducted their study to examine the association between cognition – assessed using subjective and objective measures – and return to work two years after breast cancer diagnosis.
To conduct their case series, they used the cohort of CANTO – a prospective study conducted in France that investigated treatment-related chronic toxicity in women with stage I to III breast cancer.
The study cohort included women who had been diagnosed with breast cancer at age 58 or younger and who were either employed or looking for a job.
The main outcome was return to work two years after breast cancer diagnosis.
All women underwent objective tests of cognitive function and prospective assessments of cognitive symptoms, anxiety, fatigue, and depression at diagnosis, one year after completion of treatment, and two years after diagnosis.
Lange and colleagues used multivariable logistic regression models adjusted for age, stage, diagnosis, and other factors to assess return to work status in the second year using each cognitive measure.
The analysis included 178 women (mean age 48.7 years; range 28–58). Thirty-seven (20.8%) had not returned to work in the second year.
Among those who returned to work, the likelihood of having a mastectomy appeared to be half that of those who did not return (24.1% versus 54.1%; P
The results showed associations between return to work after 2 years and several 2-year assessment outcomes. These outcome measures included lower overall cognitive impairment (1-point unit increased OR (1-point OR) = 0.32; 95% CI, 0.13–0.79), better working memory (1-point OR = 2.06; 95% CI, 1.23–3.59), higher processing speed (1-point OR = 1.97; 95% CI, 1.2–3.36), higher attentional performance (1-point OR = 1.63; 95% CI, 1.04–2.64), higher perceived cognitive ability (1-point OR = 1.12; 95% CI, 1.03–1.21), and lower depression (1-point OR = 0.83; 95% CI, 0.74–0.93).
The researchers also found associations between return to work after two years and the results of assessments conducted at baseline and one year after completion of treatment. These outcomes included higher processing speed (baseline, 1 point OR = 2.38; 95% CI 1.37–4.31; 1 year, 1 point OR = 1.95; 95% CI 1.14–3.5), higher executive performance (baseline, 1 point OR = 2.61; 95% CI 1.28–5.75; 1 year, 1 point OR = 2.88; 95% CI 1.36–6.28), and lower physical fatigue (baseline, 10 point OR = 0.81; 95% CI 0.69–0.95; 1 year, 10 point OR = 0.84; 95% CI 0.71–0.98).
“Cognitive difficulties should be assessed before returning to work to suggest appropriate treatment,” Lange and colleagues wrote.
Sources/Disclosures
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Announcement: Lange does not provide any relevant financial information. The relevant financial information of all other authors can be found in the study.
