Conclusions

This study adds to evidence of persistent cognitive challenges among BCS, specifically in episodic memory. By contrasting a naturalistic narrative task with a standardized memory task, we show that traditional assessments may overlook real-world memory difficulties. Ecologically valid measures that better reflect survivors’ lived experiences paired with a cognitive workload measure provide a more nuanced view of both memory function and the subjective effort required to complete everyday tasks. These results underscore the need for multidimensional cognitive assessments in survivorship care and support the development of tailored interventions that validate survivors’ experiences and enhance quality of life.