Reliable change in neuropsychological assessment of breast cancer survivors

Charissa Andreotti, James C. Root, Sanne B. Schagen, Brenna C. McDonald, Andrew J. Saykin, Thomas M. Atkinson, Yuelin Li, Tim A. Ahles

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


Background The purpose of this study was to enhance the current understanding and interpretation of longitudinal change on tests of neurocognitive function in individuals with cancer. Scores on standard neuropsychological instruments may be impacted by practice effects and other random forms of error. Methods The current study assessed the test-retest reliability of several tests and overarching cognitive domains comprising a neurocognitive battery typical of those used for research and clinical evaluation using relevant time frames. Practice effect-adjusted reliable change confidence intervals for test-retest difference scores based on a sample of patient-matched healthy controls are provided. Results By applying reliable change confidence intervals to scores from two samples of breast cancer patients at post-treatment follow-up assessment, meaningful levels of detectable change in cognitive functioning in breast cancer survivors were ascertained and indicate that standardized neuropsychological instruments may be subject to limitations in detection of subtle cognitive dysfunction over clinically relevant intervals, especially in patient samples with average to above average range baseline functioning. Conclusions These results are discussed in relation to reported prevalence of cognitive change in breast cancer patients along with recommendations for study designs that enhance detection of treatment effects.

Original languageEnglish (US)
Pages (from-to)43-50
Number of pages8
Issue number1
StatePublished - Jan 1 2016


  • breast cancer
  • cognition
  • neuropsychological assessment
  • survivorship

ASJC Scopus subject areas

  • Experimental and Cognitive Psychology
  • Oncology
  • Psychiatry and Mental health

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