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Breast cancer may cause brain injury, research shows

Primary breast cancer can result in significant neurological impairment

Louise Prime

Thursday, 17 November 2011

Women who survive primary breast cancer may have significant neurological impairment, especially if they have been treated with chemotherapy, shows research published in this month’s Archives of Neurology. Older and less educated women were especially vulnerable to altered brain function.

Researchers at Stanford University School of Medicine in California, US, used functional magnetic resonance imaging (fMRI) to compare profiles of brain activation in three groups of women who performed computer-based card-sorting tasks. There were 25 women with breast cancer who had had chemotherapy, 19 women with breast cancer who had not had chemotherapy, and 18 healthy female controls, all matched for age, educational level and menopausal status.

On the same day as women had their fMRI, they were assessed on processing speed, working memory, verbal fluency and subjective perception of executive functioning, as well as being screened for symptoms of depression.

Women with breast cancer, whether or not they had had chemotherapy, demonstrated significant neurological impairment – reduced activation in the left middle dorsolateral prefrontal cortex and premotor cortex – compared with healthy controls.

The authors found that women who had had chemotherapy “also demonstrated significantly reduced left caudal lateral prefrontal cortex activation and increased perseverative errors and reduced processing speed” than either of the other two groups.

Older age, and lower educational level, appeared to exacerbate the negative effects of chemotherapy on the women’s brain function.

The researchers said: “The findings of this study have important implications for the effects of primary breast cancer on brain function. Survivors of breast cancer demonstrated significantly reduced left middle dorsolateral prefrontal cortex and left medial frontal activation compared with controls, irrespective of treatment history.

“However, women in the chemotherapy group showed significantly poorer outcome, including additional reductions in left caudal lateral prefrontal function and decreased executive function compared with women not treated with chemotherapy and healthy controls.”

They conclude: “This study provides further evidence that primary breast cancer may cause measurable brain injury. Women treated with chemotherapy may show additional prefrontal deficits and have difficulty compensating for neurobiological changes such that they also show impaired executive function.”

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