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Smaller regional volumes of brain gray and white matter demonstrated in breast cancer survivors exposed to adjuvant chemotherapy

  1. Masatoshi Inagaki MD, PhD1,
  2. Eisho Yoshikawa MD, PhD2,
  3. Yutaka Matsuoka MD, PhD3,
  4. Yuriko Sugawara MD, PhD4,
  5. Tomohito Nakano MD5,
  6. Tatsuo Akechi MD, PhD6,
  7. Noriaki Wada MD7,
  8. Shigeru Imoto MD, PhD7,
  9. Koji Murakami MD, PhD8,
  10. Yosuke Uchitomi MD, PhD1,†,*,
  11. and The Breast Cancer Survivors' Brain MRI Database Group‡

Article first published online: 27 NOV 2006

DOI: 10.1002/cncr.22368

Issue

Cancer

Cancer

Volume 109, Issue 1, pages 146–156, 1 January 2007

Additional Information

How to Cite

Inagaki, M., Yoshikawa, E., Matsuoka, Y., Sugawara, Y., Nakano, T., Akechi, T., Wada, N., Imoto, S., Murakami, K., Uchitomi, Y. and and The Breast Cancer Survivors' Brain MRI Database Group (2007), Smaller regional volumes of brain gray and white matter demonstrated in breast cancer survivors exposed to adjuvant chemotherapy. Cancer, 109: 146–156. doi: 10.1002/cncr.22368

Author Information

  1. 1

    Psycho-Oncology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Chiba, Japan

  2. 2

    Division of Psycho-Oncology, Shizuoka Cancer Center, Shizuoka, Japan

  3. 3

    Division of Adult Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan

  4. 4

    Department of Psychiatry and Behavioral Science, Tokai University School of Medicine, Kanagawa, Japan

  5. 5

    Department of Psychiatry, Kitasato Institute Hospital, Tokyo, Japan

  6. 6

    Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan

  7. 7

    Division of Breast Surgery, National Cancer Center Hospital East, Chiba, Japan

  8. 8

    PET Center, Dokkyo University School of Medicine, Tochigi, Japan

  1. †

    Fax: (011) 81-4-7134-7026.

  2. ‡

    The members of the Breast Cancer Survivors' Brain MRI Database Group are Makoto Kobayakawa, MD (Department of Psychiatry, Hiroshima University Hospital, Hiroshima, Japan); Nobuya Akizuki, MD, PhD, and Maiko Fujimori, PhD (Psycho-Oncology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Chiba, Japan); in addition to the authors listed above. All members of the group are authors of the current study and meet criteria for authorship.

*Psycho-Oncology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwanoha 6-5-1, Kashiwa, Chiba 277-8577 Japan

Publication History

  1. Issue published online: 11 DEC 2006
  2. Article first published online: 27 NOV 2006
  3. Manuscript Accepted: 6 OCT 2006
  4. Manuscript Revised: 4 OCT 2006
  5. Manuscript Received: 6 SEP 2006

Funded by

  • Japanese Ministry of Health, Labor, and Welfare
  • Japan Society for the Promotion of Science
  • Japanese Ministry of Education, Culture, Science, and Technology
  • Foundation for Promotion of Cancer Research in Japan

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Keywords:

  • regional brain volume;
  • magnetic resonance imaging;
  • adjuvant chemotherapy;
  • breast cancer;
  • voxel-based morphometry

Smaller regional brain volumes were observed 1 year after breast cancer surgery in breast cancer survivors who were exposed to adjuvant chemotherapy by brain MRI. However, 3 years after their surgery, no differences were observed in the regional brain volumes between cancer survivors exposed and those unexposed to adjuvant chemotherapy.

Abstract

BACKGROUND.

Previous studies have shown cognitive impairment in breast cancer survivors who were exposed to adjuvant chemotherapy. Neural damage by chemotherapy might have played some part in these findings. The current study explored the regional brain volume difference between breast cancer survivors exposed to adjuvant chemotherapy (C+) and those unexposed (C−).

METHODS.

High-resolution 1.5-tesla brain magnetic resonance imaging (MRI) databases of breast cancer survivors and healthy controls were used. Brain images were preprocessed for optimal voxel-based morphometry. Comparisons of gray matter and white matter were performed between the C+ and the C− groups, by using MRI scans from within 1 year (the 1-year study, n = 51 and n = 55, respectively) or 3 years after their cancer surgery (the 3-year study, n = 73 and n = 59, respectively). As exploratory analyses, correlation analyses were performed between indices of the Wechsler Memory Scale-Revised and regional brain volume where the volume were significantly smaller. As a reference, MRI scans of cancer survivors were compared with those of healthy controls (n = 55 for the 1-year study and n = 37 for the 3-year study).

RESULTS.

The C+ patients had smaller gray matter and white matter including prefrontal, parahippocampal, and cingulate gyrus, and precuneus in the 1-year study. However, no difference was observed in the 3-year study. The volumes of the prefrontal, parahippocampal gyrus, and precuneus were significantly correlated with indices of attention/concentration and/or visual memory. Comparisons with healthy controls did not show any significant differences.

CONCLUSIONS.

Adjuvant chemotherapy might have an influence on brain structure, which may account for previously observed cognitive impairments. Cancer 2007. © 2006 American Cancer Society.

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