Recent advances in early detection and treatment of breast cancer have led to increasing numbers of long term survivors of breast cancer. There is a growing concern about the potential adverse effects of chemotherapy on cognitive functioning.
The current study examines the neuroanatomical correlates of late neurocognitive effects of chemotherapy in elderly breast cancer survivors who have survived more than ten years and were exposed to chemotherapy at the time of their cancer treatment.
The participants in this study are 30 women breast cancer survivors in the age range of 65-81 years. In this cross sectional design, regional brain volumes measured using magnetic resonance imaging were correlated with cognitive test scores using multiple regression analyses. The test scores from Wisconsin Card Sorting Test and Trail Making Test B are used as measures of executive function. The test scores from the Letter Number Sequencing subset of the Wechsler Adult Intelligence Scale (WAIS) are used for measures of working memory.
We found support for the hypothesized association between reduction in performance on specific neuropsychological tests and reduced volumes predominantly in the frontal, temporal and subcortical white matter regions. These results suggest that the frontal, temporal and subcortical white matter region are a neuroanatomical correlate of cognitive impairment seen in our study population.
Future research will be needed to discern whether the structural correlates of cognitive impairment seen in long term cancer survivors is likely to be developed as an imaging marker for cognitive evaluation and rehabilitation.