J Clin Oncol: The chief culprit of brain cognitive decline after breast cancer chemotherapy

Chemotherapy brain: 20% to 40% of breast cancer patients may experience cognitive decline in memory, attention, thinking and other brain functions after chemotherapy, which may last until the rehabilitation period and interfere with daily life skills and quality of life
.

Predicting breast cancer patients who are at risk of brain dysfunction after chemotherapy before chemotherapy will help improve patient treatment

Breast cancer

On September 30, 2021, the journal J Clin Oncol.
published an online research report from the National Cancer Institute of the Netherlands and the University of Amsterdam, which discussed the risk factors and prediction methods of brain cognitive decline after breast cancer chemotherapy
.

On September 30, 2021, the journal J Clin Oncol.
published an online research report from the National Cancer Institute of the Netherlands and the University of Amsterdam, which discussed the risk factors and prediction methods of brain cognitive decline after breast cancer chemotherapy
.

Screening process

Screening process

De Ruiter MB et al.
carried out a case-control study on breast cancer patients before receiving anthracycline chemotherapy (52 cases) and 6 months (49 cases), 2 years (32 cases) and 3 years (32 cases) after chemotherapy.
Psychological questionnaire scoring and magnetic resonance examination, at matching time intervals for breast cancer patients without chemotherapy (39 cases, 39 cases, 23 cases, 19 cases) and cancer-free controls (44 cases, 37 cases, 29 cases, 28 cases) Perform neuropsychological questionnaire scoring and brain magnetic resonance examination
.

Through multi-factor standardized comparison, the degree of deviation of cognitive characteristics between the patient group and the control group was analyzed
.

According to the anisotropy score of MRI diffusion tensor imaging, quantitative analysis of the microstructure of the white matter before treatment

De Ruiter MB et al.
found that the anisotropic score FA can independently predict early (6 months, P=0.
013) and late (3 years, P<0.
001) cognitive decline in breast cancer patients after chemotherapy , which is related to age, pre-morbid IQ, Baseline fatigue has nothing to do with baseline cognitive complaints, and it cannot predict cognitive decline in breast cancer patients who have not been treated with chemotherapy and cancer-free controls
.

FA can independently predict early (6 months, P=0.
013) and late (3 years, P<0.
001) cognitive decline in breast cancer patients after chemotherapy.
FA can independently predict early (6 months, P= 0.
013) and late (3 years, P<0.
001) cognitive decline

Voxel analysis shows that the white matter tracts are essential for cognitive function
.

The white matter tract is essential for cognitive function
.

The white matter tract is essential for cognitive function

Scatter plot of the correlation between baseline FA and cognitive decline in 3 follow-ups

Scatter plot of the correlation between baseline FA and cognitive decline in 3 follow-ups

Brain FA before breast cancer chemotherapy may reflect brain white matter reserves and may be a risk factor for cognitive decline after breast cancer chemotherapy
.

Pre-chemotherapy screening of patients with low white matter reserves will help improve the prognosis of patients

Brain FA before breast cancer chemotherapy may reflect brain white matter reserves and may be a risk factor for cognitive decline after breast cancer chemotherapy

de Ruiter MB, Reneman L, Kieffer JM, Oldenburg HSA, Schagen SB.

de Ruiter MB, Reneman L, Kieffer JM, Oldenburg HSA, Schagen SB.
Brain White Matter Microstructure as a Risk Factor for Cognitive Decline After Chemotherapy for Breast Cancer.
J Clin Oncol.
2021 Sep 30:JCO2100627.
doi: 10.
1200/JCO.
21.
00627 .
Epub ahead of print.
PMID: 34591652.
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