Abstract PS1-03-26: Changing patterns of attention network in Breast Cancer Survivors

Abstract Background: Cognitive impairments, particularly in attention, are frequently reported among breast cancer survivors undergoing systemic anticancer therapies. However, the changes across distinct attention functions remain poorly characterized. This study aims to investigate alterations in the attention networks among breast cancer survivors treated with chemotherapy and tamoxifen and to explore their association with treatment duration. Methods: Between September 2018 and December 2024, a total of 435 breast cancer survivors who underwent chemotherapy followed by tamoxifen treatment, along with 242 age-matched healthy female controls were recruited. The Attention Network Test was utilized to assess the efficiency of attentional networks. Linear regression and restricted cubic spline analyses were employed to evaluate changes in the three attention networks among breast cancer survivors. Results: Compared with healthy controls, breast cancer survivors exhibited significantly reduced efficiency in the alerting (P < .001) and executive (P < .001) networks, while the orienting network efficiency remained intact. Notably, the executive network demonstrated a nonlinear (V-shaped) trajectory over treatment duration, characterized by an initial improvement peaking around at approximately 15 months, followed by a subsequent decline (nonlinear P < .001). This pattern was consistent across different chemotherapy subtypes. The alerting network showed persistent impairment throughout the five-year observation period (linear P = .247), potentially indicative of underlying neural alterations. Conclusions: Systemic anticancer treatments in breast cancer survivors are associated with selective impairments in attention networks, characterized by deficits in alerting efficiency and a V-shaped trajectory of executive function changes over a five-year period. These findings suggest that early chemotherapy-related cognitive effects may be transient, whereas prolonged tamoxifen use could contribute to persistent executive dysfunction. Longitudinal studies are essential to elucidate the underlying causal mechanisms and inform strategies for cognitive rehabilitation. Citation Format: F. li, J. Li, X. Chen. Changing patterns of attention network in Breast Cancer Survivors [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS1-03-26.