Longitudinal Executive Function and Perceived Stress in Women Undergoing Breast Cancer Treatment

Breast cancer is among the most common cancers worldwide, affecting approximately one in eight women over the course of their lifetime. Following breast cancer treatment, 13 to 17 percent of survivors report cognitive impairment. Cancer-related cognitive impairment among breast cancer survivors remains poorly characterized due to inconsistencies in measurement approaches and variability in longitudinal findings. This study examined changes in executive function and perceived stress among twelve women undergoing treatment for early-stage breast cancer using a longitudinal design. Participants completed pre- and post-treatment behavioral assessments using a cognitive neuroscience-based Cued Cognitive Flexibility task that measured reaction time and accuracy across cognitive flexibility and interference control subprocesses. Perceived stress was assessed using the Perceived Stress Scale, and regression analyses evaluated whether baseline stress or changes in stress predicted executive function outcomes. Results showed no significant pre- to post-treatment differences in overall reaction time, accuracy, cognitive flexibility, or interference control. Additionally, neither baseline perceived stress nor changes in stress significantly predicted accuracy. These findings suggest that substantial executive dysfunction or stress-related behavioral effects are not universally observed following breast cancer treatment, thus highlighting the heterogeneity of cancer-related cognitive impairment and the need for larger longitudinal studies using more sensitive assessment approaches.