Chemotherapy-Induced Cognitive Impairment (‘Chemo Brain’) in Breast Cancer Survivors

Abstract

Background: Chemotherapy-induced cognitive impairment, commonly referred to as ‘chemo brain,’ is a well-documented side effect affecting breast cancer survivors, yet its prevalence, characteristics, and contributing factors remain incompletely understood. This study aimed to assess the frequency and pattern of cognitive deficits in breast cancer survivors post-chemotherapy and to examine associated psychological and clinical predictors. Methods: A cross-sectional study was conducted involving 150 female breast cancer survivors aged 30–65 years, assessed 6 to 24 months after completing chemotherapy. Cognitive function was evaluated using standardized neuropsychological tests focusing on memory, attention, executive function, and verbal fluency. Subjective cognitive complaints and psychological variables such as fatigue, anxiety, and depression were measured through validated questionnaires. Multiple regression analysis was performed to identify predictors of cognitive impairment. Results: Objective cognitive impairment was observed in 56% of participants, predominantly affecting memory (43%) and attention/processing speed (39%). Subjective cognitive complaints correlated significantly with objective test results (r = 0.56, p < 0.001). Fatigue and mood disturbances were significantly higher in cognitively impaired survivors. Age (β = 0.32, p = 0.005), time since chemotherapy (β = -0.25, p = 0.02), and fatigue (β = 0.38, p < 0.001) emerged as significant predictors of cognitive impairment. Conclusion: Cognitive impairment is a common and impactful sequela among breast cancer survivors following chemotherapy, closely associated with fatigue and psychological distress. These findings underscore the need for comprehensive survivorship care integrating cognitive and emotional health assessment, alongside development of targeted interventions to improve survivors’ quality of life.