Attention and symptom distress in women with and without breast cancer

Background: The cognitive capacity to direct attention (CDA) is essential f or self-care and independent functioning. Older women may be more vulnerabl e to fatigue-related losses in CDA following surgery for breast cancer. Nor mal functional variations in CDA associated with aging might affect attenti onal responses in older women newly diagnosed with breast cancer, and facto rs such as extent of surgery or symptom distress might influence CDA over t ime. Objectives: To examine (a) differences in CDA and symptom distress in older women newly diagnosed with breast cancer as compared to a control group of older women without breast cancer; (b) the pattern of change in CDA and sy mptom distress from the pretreatment period to 3 months after surgery; and (c) to examine the relationship of CDA with symptom distress and extent of surgery over time. Methods: Women, 55 to 79 years of age, newly diagnosed with breast cancer ( N = 47), were assessed with measures of CDA and symptom distress: (a) befor e surgery, (b) at 2 weeks postsurgery, and (c) 3 months postsurgery. To acc ount for normal variations associated with aging, 48 women of similar age w ithout breast cancer were assessed following a routine screening mammogram and 3 months later. Results: Before treatment, the breast cancer group scored significantly low er than the control group (p < .05) on measures of CDA and higher on sympto m distress. Repeated measures ANOVA showed significant main effects of grou p, but not time, for the measures of CDA and symptom distress with the brea st cancer group having worse status than the control group. For CDA only, t here was a significant group by time interaction effect (p = .005) so that the breast cancer group showed a gradual gain in CDA over time. Conclusions: Reduced performance in a cognitive function was observed befor e treatment and found to persist over an extended interval in older women n ewly diagnosed with breast cancer.