Cancer Treatment and Memory in Breast Cancer Survivors: Differential Effects on Detailed Episodic and Gist-Like Memory Recall Over Time.

Breast cancer survivors (BCS) frequently experience chemotherapy-related cognitive impairment, including episodic memory deficits. This study examined the long-term impact of cancer treatment on memory for naturalistic events, using film clips to assess recall of central (gist-like elements; reflects the story narrative) and peripheral (episodic elements; sensory or contextual details related to the event) details. While memory for both types of details typically declines over time, peripheral details are especially vulnerable to decline, and are sensitive to impairment in individuals with medial temporal lobe disruption. Participants (BCS, n = 42; noncancer controls, NC, n = 41) viewed 40 short film clips (encoding). Memory for the clips' content was tested at two timepoints: immediately following encoding (20 clips; immediate retrieval) and after a 7-day delay (20 clips; delayed retrieval). BCS recalled significantly fewer peripheral details than NC, whereas recall of central (gist-like) information did not differ between groups. No group differences were observed across individual sub-categories of peripheral details, temporal sequencing, or the rate of forgetting over the 7-day delay. Subjective memory ratings mirrored objective performance, with BCS reporting lower memory vividness than NC, while reporting comparable memory for story content. These findings suggest that chemotherapy may reduce the overall richness of episodic event representations while preserving central, schematic aspects of memory and the temporal organization of events. Naturalistic memory paradigms that assess the qualitative features of event memory may provide a sensitive approach for detecting subtle treatment-related cognitive changes in cancer survivors.