9041 Background: A qualitative study has revealed that Asian breast cancer patients attributed their post-chemotherapy cognitive disturbances to psychosocial distress. To validate this claim, we aim to examine perceived cognitive disturbances, anxiety and quality of life (QoL) in Asian breast cancer patients and to identify clinical and psychosocial factors associated with perceived cognitive disturbances. Methods: A prospective, observational study was held at the largest cancer center in Singapore. Chemotherapy (CT) and non-chemotherapy (non-CT) receiving breast cancer patients completed self- reported questionnaires to assess the following domains: patients’ perceived impact of chemotherapy on cognitive disturbances (FACT-Cog), health-related QoL (EORTC QLQ-C30) and anxiety (Beck Anxiety Inventory). Multiple regression was conducted to delineate factors associated with perceived cognitive impairment. Results: A total of 166 (1:1 CT/non-CT) patients were recruited (age: 54.1±10.2 years; 78.9% Chinese; 53.6% post-menopausal). Most of the CT patients received anthracycline-based chemotherapy (93.1%) and anti-hormonal therapy (69.4%). Comparing to non-CT patients, CT patients experienced more fatigue (QLQ-C30 fatigue scores: 22.2 vs 33.3 points; p=0.005), more significant anxiety (8.6% vs 21.9%; p=0.002), and more cognitive disturbances (FACT-Cog scores: 110 vs 124 points; p<0.0001). Regression model identified chemotherapy, anti-hormonal therapy, emotional functioning and global health status to be strongly associated with cognitive disturbances in Asian breast cancer patients. The interacting effect between anxiety and fatigue, comparing to fatigue alone, was more associated with cognitive disturbances (β=-0.212; p=0.032 vs β=-0.07; p=0.25, respectively). Conclusions: This is the first study to demonstrate that Asian breast cancer patients experiencing both fatigue and anxiety are more predisposed to cognitive disturbances. Post-chemotherapy cognitive changes are observed in our patients, and our results suggest that psychosocial factors are impactful to identify cancer patients who are more susceptible to cognitive disturbances.
Prognostic significance of psychosocial factors in African-American and white breast cancer patients