Chemotherapy-Related Cognitive Dysfunction in Breast Cancer Survivors: A Systematic Review

Objectives: The major aims of this integrative review were to identify: 1) specific cognitive domains affected by chemotherapy; 2) predictors of cognitive dysfunction related to chemotherapy; 3) reported underlying mechanisms of chemotherapy-related cognitive dysfunction, and 4) clinical and research implications of chemotherapy-related cognitive dysfunction (CRCD) among breast cancer survivors. Methods: A computerized search of published research articles through the health journal databases of PubMed, CINAHL, EMBASE, and Web of Science was performed by using the keywords "chemotherapy," "cognitive dysfunction," "cognitive impairment," "cognitive decline," "breast cancer," and "breast carcinoma." References were screened according to inclusion and exclusion criteria. Results: After screening the titles and abstracts of 639 articles, 20 research studies were identified that focused on chemotherapy-related cognitive dysfunction in breast cancer for the final analysis. The 20 studies included: one longitudinal study, eleven prospective studies, two case-control studies, two retrospective studies, and four cross-sectional studies. The analysis of these 20 research studies contributed new knowledge about cognitive domains being affected by chemotherapy, risk factors for CRCD and underlying mechanisms of CRCD. Conclusion: This systematic review indicates significant clinical implications of early assessment and early interventions for CRCD to assist breast cancer survivors.