• David E Vance, Jennifer Sandson Frank, Jennifer Bail, Kristen L Triebel, Lindsay M Niccolai, Adam Gerstenecker, and Karen Meneses.
• Author Affiliations: School of Nursing (Drs Vance, Frank, and Meneses and Ms Bail) and Department of Neurology (Drs Trievel and Gerstenecker and Ms Niccolai), University of Alabama at Birmingham.
• Cancer Nurs. 2017 Jan 1; 40 (1): E11-E27.

BackgroundCognitive deficits are distressing adverse effects of chemotherapy that have a negative effect on quality of life in breast cancer survivors (BCSs). Cognitive deficits in cancer survivors are a top research and clinical practice priority.ObjectiveThe aims of this study were to describe cognitive deficits that occur after chemotherapy, describe deficits in BCSs treated with chemotherapy within a framework of cognitive reserve and neuroplasticity, and discuss cognitive interventions (ie, cognitive training interventions, compensatory strategies with cognitive training interventions, pharmacological interventions, and complementary and integrative medicine interventions).MethodsPubMed search yielded 21 intervention studies of cognitive deficits in BCSs.ResultsCognitive training interventions and compensatory strategies with cognitive training resulted in improvement of cognitive deficits. Methylphenidate did not result in cognitive improvement. Modafinil showed improvement in attention. Some complementary and integrative medicine interventions are promising.ConclusionsCognitive training has been most beneficial. Effectiveness of pharmacologic and complementary and integrative medicine interventions has not yet been established.Implications For PracticeWhile limited evidence is available to guide clinical management of cognitive deficits in BCSs, validating patients' symptom experience and evaluating co-occurring symptom clusters such as fatigue, sleep, and depression, are suggested.

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