Abstract

Patients with breast cancer treated with chemotherapy may develop neuropsychiatric symptoms, including fatigue and depression. The authors discuss the potential use of structural neuroimaging in the identification of these patients. Findings from neuroimaging studies improve our understanding of the wide-ranging neurobiological changes in breast cancer patients. We set out to determine whether neuroimaging studies had identified brain abnormalities in association to the presence of breast cancer. A qualitative systematic review of all structural neuroimaging studies in subjects with breast cancer was carried out. Studies were identified using general medical and specific databases as well as search engine such as PUBMED, EMBASE and COCHRANE based on current contents and other secondary sources. Systematic review of results from ten studies led to the observation that different brain areas might be vulnerable to the presence of breast cancer. The most striking observation was the extreme variability of the results observed in different studies. Some variability in the results was associated to different imaging analysis, presence of neuropsychiatric symptomatology (depression and post traumatic stress) and use of co adjuvant chemotherapy. Evidence from neuroimaging studies has suggested areas of the brain that may be damaged by the presence of breast cancer or direct effect of chemotherapy. The clinical implications of these neuroimaging findings need to be investigated further, as they challenge traditional therapeutic approaches.

Key words: Breast cancer, neuroimage, depressive symptoms, chemotherapy, cognitive function.