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Cognitive changes after breast cancer treatment are often attributed to chemotherapy, without considering other important factors such as other treatments (e.g., surgery, radiation, endocrine therapy (ET)). We compared neuropsychological functioning in the domains of learning, memory, attention, visuospatial, executive function, and processing speed according to primary breast cancer treatment exposures in early survivorship, before the initiation of ET ( n  = 189). We were also interested in the association of neuropsychological functioning with select clinical, psychological, and behavioral factors. Compared to those who only underwent surgery ( n  = 28), all neuropsychological domain scores were comparable in a sample of breast cancer survivors with different treatment exposures, i.e., radiation therapy ( n  = 64), chemotherapy ( n  = 20), or both ( n  = 77),  p ’s < 0.05, adjusted for age, IQ, depression, and time since treatment completion. Physical fatigue, pain, and sleep correlated with several cognitive domains regardless of treatment exposure. There are minimal treatment-related neuropsychological differences on neuropsychological measures in early breast cancer survivorship, but the influence of other co-occurring symptoms warrants attention.

Cognitive function following breast cancer treatment and associations with concurrent symptoms