Cancer of the breast is a tumor that starts in the cells of the breast with the potential to invade other tissues (malignant tumor) and it is the most common incident site of cancer in women worldwide[1]In Asia, 44% of the world’s cases of death are due to breast cancer and the percentage of new breast cancer cases diagnosed is overall 39% in the world. In India, approximately 25% of female cancer cases are breast cancer[2]. Compared to western countries, the mortality rate due to breast cancer is three-fold in the countries of South Asia[3]. In the past 25 years, the trend of breast cancer is increasing in women between 25 to 40 years of age in India[2].

A web-based survey done in 2019, found out that the prevalence of Cancer Related Cognitive Impairment (CRCI) among breast cancer was 8.23%. For cancer-related, to gynecology it was 9.10% and among hematological cancer population it was 8.33% and other types of cancer constituted 8.86% of the cancer-related cognitive impairment cases. The major domains that are affected in cancer-related cognitive impairment include memory, executive functions, attention, speed of processing along with visual and spatial skills, working memory, new learning and language among the other aspects which are affected according to the American Cancer Society. There is a reduction in density and volume of grey matter along with changes in the white matter due to cancer-related cognitive impairment as per research[4].

The research has demonstrated the presence of cancer-related cognitive impairment particularly in patients with cancer of the breast. To prevent the worsening of the cancer stages and for increasing the survival rate of the cancer patients, radiation therapy, chemotherapy and other adjuvant treatments have been used but they can lead to severe side effects among which there can be long-term and short-term cognitive issues which will be disabling for the patients. These cognitive issues can also majorly affect the ability of the patient to engage in hobbies, study, or work and continue with healthy relationships with friends, family, and others and follow healthy lifestyle habits which in turn affect the quality of life negatively[5].Anxiety, depression, adjustment problems, level of coping and fatigue are the affective symptoms of cancer-related cognitive impairment[5], [6]. The process of hippocampal and prefrontal cortical neurogenesis in the brain may be altered by cancer itself or the treatment of cancer[5].

A decline in cognitive function may occur with radiotherapy which may be recovered during radiotherapy or shortly after the radiotherapy or it may persist for several months or several years after the radiotherapy, and it may be due to irradiation which induces inflammation and elevates circulating levels of proinflammatory cytokines and among these cytokines, levels of plasma interleukins IL-6 play an important role in cognitive impairment[7], [8]. Blood-brain barrier’s integrity is changed due to radiotherapy along with changes in the functioning of microglia, oligodendrocytes and transmission through synapses[9].

Cancer-related cognitive impairment is highly prevalent in approximately 40% of patients before treatment, up to 75% of patients during treatment and up to 60% of the patients with a decline in cognitive function following completion of treatment after many years[6]. Several pharmacological therapies have been investigated for the management of Cancer-related cognitive impairment but there is very little evidence which suggests that these have a potential effect on cognitive impairment or decline[10]. Cognitive-based training, rehabilitative cognitive approaches, cognitive behavioral strategies and exercise-based interventions are some of the non-pharmacological approaches for the management of cognitive deficits related to cancer [10], [11].

National Comprehensive Cancer Network (NCCN) 2020 recommends initially low-intensity duration exercises and then progression to high intensity as the condition changes [12]. With regular physical exercises there is improvement in the blood flow to the cerebral cortex along with increased neurogenesis and brain-derived factors like neurotrophins[5].

Tai Chi which is rendered as the paramount top most supreme ultimate boxing system started as an ancient Chinese form of martial art. Tai Chi is an exercise which includes slow, relaxed movements for the overall development of oneself [13]. Tai Chi is a whole-body exercise which involves the concentration of the mind and meditation for the soul spiritually. Tai Chi practice has key features which include mindful movements (awareness of movement in the present), imagination (motor imagery), alignment of the body structure (efficient and effective movements and posture), relaxation techniques, flexibility, balance, strength, diaphragmatic breathing, social interactions and body integrity along with spirituality-based health practice[14].

Tai Chi is effective for improving Quality of Life (QOL) issues such as fatigue and sleep as well as stress, anxiety and depression[15], [16]. But there is limited evidence of the effect of Tai Chi on cognitive function in breast cancer patients. There are no studies on the effect of Tai Chi with primary outcome measurement of cognitive function in breast cancer patients undergoing treatment. There are no studies done on the effect of short-term Tai Chi on cognitive function in breast cancer patients undergoing radiotherapy during their hospital stay.