A report in the November issue of the Archives of Neurology, one of the JAMA/Archives journals outlines cases of women who survived breast cancer and showed neurological impairment. The problem seems to be markedly worse in those who received chemotherapy compared with those that did not.

Breast cancer is one of the most common public health issues, with global incidence estimated at 39 per 100,000 individuals per year. Although primary Breast Cancer has not in the past been associated with neurological problems, a growing body of evidence supports the case that patients are at increased risk for altered brain structure and function.

Shelli R. Kesler, Ph.D., and colleagues at Stanford University School of Medicine, Stanford, Calif., conducted an observational study to find out if profiles of brain activation were different among breast cancer survivors treated with or without chemotherapy, compared with healthy control women. The study included more than sixty women matched for age and other demographic variables :

  • 25 women with breast cancer who received chemotherapy
  • 19 women with breast cancer who did not receive chemotherapy
  • 18 healthy female controls

The women were asked to perform various tasks, and the researchers used functional MRI to measure activation in several areas of the brain.

The report states :

“Women with BC demonstrated significantly reduced activation in the left middle dorsolateral prefrontal cortex and premotor cortex compared with healthy controls … The chemotherapy group also demonstrated significantly reduced left caudal lateral prefrontal cortex activation and increased perseverative errors and reduced processing speed compared with the other two groups.”

In addition it was deemed possible that chemotherapy may well affect brain function according to the person’s level of education and with increased age. Clearly a side effect of chemotherapy that is seldom discussed, would appear to be a duller brain.

The report concludes that :

“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.”

Written by Rupert Shepherd