背景與重要性：輔助性化學治療是乳癌主要治療方式之一。許多研究表示乳癌病人在接受化學治療後會有認知功能受損情形，以致於無法如同以往精準快速的做出日常生活決定、應付職場要求等。由於乳癌的好發年齡為45歲至54歲，許多病人於治療過程中仍持續在工作，若在治療過程中認知功能有受損，則會對於生活、工作、治療的理解與決策造成影響。但化學治療是否會使認知功能受損之結果仍未有定論，目前對於乳癌病人化學治療過程中認知功能的變化軌跡亦不清楚。
目的：探討健康受試者與乳癌病人接受輔助性化學治療CEF與AC處方期間的認知功能變化與差異。
方法：採縱貫性研究。以方便取樣選取接受Cyclophosphamide、Epirubicin及5-FU處方（CEF組）及Doxorubicin及Cyclophosphamide處方（AC組）之33位乳癌病人及18位健康組為對象；研究工具採用蒙特利爾認知評估測量認知功能；於接受輔助性化學治療過程的評估，每次間隔6週，共測量4次。使用SPSS24.0版進行資料統計與分析，描述人口學分析、認知功能各層面的變化、差異及相關因素的影響。
結果：三組的『視覺空間/執行』分數有隨測量時間而下降，但『整體認知功能』無顯著差異，且隨著時間有愈來愈好的趨勢；僅有CEF組於『視覺空間/執行』、『命名』、『延遲記憶』等認知功能層面皆顯得較AC組和健康組差。年齡愈大『整體認知功能』愈差（p< .05），教育程度（p< .01）、血紅素（p= .03）愈高及已停經者（p= .03）之『整體認知功能』愈好，而焦慮（p= .47）、憂鬱（p= .28）、疲憊（p= .08）等因素皆不會顯著影響『整體認知功能』。
結論：乳癌病人使用CEF或AC處方後的認知功能無顯著差異，但使用蒙特利爾認知評估可能會導致有練習效應的發生，以致於認知功能受損程度或許有被低估的可能。

Many studies indicated that patients with breast cancer suffered from cognitive impairment, especially those who underwent the adjuvant chemotherapy. However, it is not clear that the trajectory of cognitive function changing among patients with breast cancer therapy. The purpose of this study was to explore the trend and difference of cognitive function among breast cancer patients undergoing adjuvant chemotherapy.
This was a longitudinal study. Purposive sampling was applied to enroll 33 patients underwent adjuvant chemotherapy (Doxorubicin, Cyclophosphamide (AC) and Cyclophosphamide, Epirubicin, 5-fluorouracil (CEF) regimens) at early stage of breast cancer. Eighteen healthy persons were recruited as a control group. The cognitive function among the subjects was evaluated using Montreal Cognitive Assessment (MoCA). Questionnaires were delivered to subjects at the beginning, during and after adjuvant chemotherapy. Healthy group was contacted at the same interval time. Generalized estimating equations technique was applied for data analysis to explore the relationships among factors.
There was no significant difference in the cognitive function among groups. Older age was associated with worse cognitive function (p < .05). Subjects with menopause status (p = .03), higher education level (p < .01) and higher hemoglobin value (p = .03) had better the cognitive function. Factors such as anxiety (p = .47), depression (p = .28), and fatigue (p = .08) did not significantly affect the cognitive function. Practice effects were found in cognitive function assessment using MoCA.

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