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Alterations in brain structure related to breast cancer and its treatment: chemotherapy and other considerations

  • SI: Neuroimaging Studies of Cancer and Cancer Treatment
  • Published:
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Abstract

Cognitive effects of cancer and its treatment have been a topic of increasing investigation over the past ~30 years. Recent studies have focused on better understanding the neural correlates of these effects, with an emphasis on post-chemotherapy effects in breast cancer patients. Structural MRI studies have utilized both automated and manual approaches to quantify gray and white matter characteristics (e.g., regional volume and density) in breast cancer patients treated with chemotherapy relative to patients who did not receive chemotherapy and/or healthy controls. While most work to date has been retrospective, a small number of baseline (pre-systemic therapy) and prospective longitudinal studies have been conducted. Data have consistently shown lower gray and white matter volume and density in patients treated with chemotherapy, particularly in frontal and temporal brain regions. Host factors and/or the cancer disease process and other therapies (e.g., antiestrogen treatment) also seem likely to contribute to the observed differences, though the relative contributions of these effects have not yet been investigated in detail. These structural abnormalities have been shown to relate to subjective and objective cognitive functioning, as well as to biological factors that may help to elucidate the underlying mechanism(s). This review examines the currently available published observations and discusses the major themes and promising directions for future studies.

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Acknowledgements

This work was supported in part by the National Cancer Institute (R01 CA101318, R01 CA087845, P30 CA082709, and R25 CA117865) and the National Institute on Aging (R01 AG19771, P30 AG10133 and U24 AG021886), the Indiana Clinical and Translational Sciences Institute (U54 RR025761, C06 RR020128 and S10 RR027710), and the Indiana Economic Development Corporation (grant # 87884).

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Correspondence to Brenna C. McDonald.

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McDonald, B.C., Saykin, A.J. Alterations in brain structure related to breast cancer and its treatment: chemotherapy and other considerations. Brain Imaging and Behavior 7, 374–387 (2013). https://doi.org/10.1007/s11682-013-9256-x

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