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Recommendation
Cognitive impairment – Assessment and management
If cognitive impairment in association with breast cancer or its treatment is suspected, assess for and treat reversible contributing factors (e.g. thyroid dysfunction), discuss coping strategies, and offer referral to an appropriate health professional (geriatrician, neurologist, psychiatrist or psychologist) experienced in the assessment and management of cognitive impairment.
It is recommended that primary care clinicians should
(i) ask patients if they are experiencing cognitive difficulties;
(ii) should assess for reversible contributing factors of cognitive impairment and optimally treat when possible; and
(iii) should refer patients with signs of cognitive impairment for neurocognitive assessment and rehabilitation, including group cognitive training if available (Levels of evidence – 0, 1A, and 1A, respectively).
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How this guidance was developed
This recommendation was adapted from the ACS/ASCO 2016 guidelines (US). The source recommendations were based on a systematic review conducted to April 2015 and were not graded by the source guideline authors. In the adaptation of the source recommendations it was made clear that the recommendation relates to cognitive impairment that can arise as a consequence of the cancer and/or its treatment, i.e. cancer-related cognitive impairment, particularly from chemotherapy.
Related guidance by topic
Cognitive impairment – Assessment and management
Recommendation
If cognitive impairment in association with breast cancer or its treatment is suspected, assess for and treat reversible contributing factors (e.g. thyroid dysfunction), discuss coping strategies, and offer referral to an appropriate health professional (geriatrician, neurologist, psychiatrist or psychologist) experienced in the assessment and management of cognitive impairment.
Principles in action
Patient-centred care
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Multidisciplinary care
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Supportive care
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Care coordination
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Communication
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This recommendation was adapted from the ACS/ASCO 2016 guidelines (US). The source recommendations were based on a systematic review conducted to April 2015 and were not graded by the source guideline authors. In the adaptation of the source recommendations it was made clear that the recommendation relates to cognitive impairment that can arise as a consequence of the cancer and/or its treatment, i.e. cancer-related cognitive impairment, particularly from chemotherapy.
Related guidance by topic
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Wellbeing & psychosocial care
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