Cognitive Difficulties and Return to Work 2 Years After Breast Cancer Diagnosis

By: Julia Cipriano, MS
Posted: Friday, November 1, 2024

In a longitudinal case series study of the nationwide French Cancer Toxicities (CANTO) cohort, which was published in JAMA Network Open, patients who returned to work 2 years after being diagnosed with breast cancer demonstrated higher cognitive speed performance before and after treatment. Marie Lange, PhD, of Normandie Université, Caen, France, and colleagues recommended that cognitive difficulties be assessed before return to work after breast cancer treatment to propose suitable management.

Data were obtained from a substudy of the CANTO cohort, CANTO-Cog, which investigated cognitive functioning in 494 patients with stage I to III disease. The final sample included 178 of these individuals (aged 58 or younger) who were either working or looking for a job at diagnosis. Cognitive functioning, cognitive symptoms, anxiety, depression, and fatigue were prospectively assessed at diagnosis (baseline), 1 year after the completion of treatment, and 2 years after diagnosis.

A total of 20.8% of patients did not return to work at year 2 after diagnosis of breast cancer. Those who returned to work seemed to have a higher (ie, professional) occupational class and were less likely to have undergone mastectomy (24.1% vs 54.1%).

Based on the 2-year assessment, return to work at year 2 was associated with lower overall cognitive impairment (1-point odds ratio [OR] = 0.32), higher working memory performance (1-point OR = 2.06), higher processing speed performance (1-point OR = 1.97), and higher attention performance (1-point OR = 1.63), as well as higher perceived cognitive abilities (1-point OR = 1.12) and less depression (1-point OR = 0.83). Return to work at year 2 was found to be associated with the following measures at baseline and year 1: higher processing speed performance (1-point OR = 2.38 and 1.95, respectively); higher executive performance (1-point OR = 2.61 and 2.88); and less physical fatigue (10-point OR = 0.81 and 0.84).

Disclosure: Dr. Lange reported no conflicts of interest. For full disclosures of the other study authors, visit jamanetwork.com.

JAMA Network Open

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