The findings of a recent study add to the growing body of evidence of neurologic impairment associated with primary breast cancer. Although these problems can occur irrespective of the patient’s treatment history, women who have undergone chemotherapy appear to fare the worst.

The observational study involved 25 women with breast cancer who had received chemotherapy, 19 women with breast cancer who had not received chemotherapy, and 18 healthy female controls, all matched for age and other demographic variables. When the women were asked to perform various tasks, functional MRI showed that those with breast cancer demonstrated significantly reduced activation in the left middle dorsolateral prefrontal cortex and premotor cortex compared with healthy controls.

The subset of cancer patients who had undergone chemotherapy also demonstrated significantly reduced left caudal lateral prefrontal cortex activation and reduced processing speed compared with healthy controls or women with breast cancer who had not received chemotherapy. The findings suggested that the negative effects of chemotherapy on brain function may be exacerbated by such factors as increased age and lower educational level.

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“This study provides further evidence that primary breast cancer may cause measurable brain injury,” wrote Shelli R. Kesler, PhD, and co-investigators at Stanford University School of Medicine, Stanford, California, in Archives of Neurology (2011;68[11]:1447-1453). “Women treated with chemotherapy may show additional prefrontal deficits and have difficulty compensating for neurobiological changes such that they also show impaired executive function.”