Cognitive Rehabilitation Following Breast Cancer Treatment

Breast cancer survivors often self-report cognitive deficits, primarily in executive

functioning (planning, problem solving, multitasking), memory, and processing speed after

cancer treatment, i.e., cancer-related cognitive impairment (CRCI). The prevalence of

CRCI following breast cancer is as high as 78% and can persist chronically after

treatment has ended. In other health conditions associated with cognitive impairment,

such as traumatic brain injury, the only evidence-based recommended practice standard for

deficits in executive function is metacognitive strategy training (MCST). In this

approach, participants are taught a general cognitive strategy that can be applied in

known and novel contexts to devise task specific strategies to successfully engage in an

activity. While the cognitive deficits identified in and described by breast cancer

survivors seem quite amenable to MCST, there is no study in the published literature

which measures the efficacy of MCST on CRCI. The Cognitive Orientation to daily

Occupational Performance (CO-OP) approach is a MCST intervention in which subjects are

taught a general cognitive strategy that can be applied in known and novel contexts to

devise task specific strategies to engage in an activity. Preliminary data suggest that

CO-OP may have a positive impact on subjective and objective cognitive performance in

breast cancer survivors with CRCI. Further, this study will evaluate the

neurophysiological underpinnings associated with treatment changes through the use of

neuroimaging methods.