Abnormal regional brain metabolism in breast cancer survivors after adjuvant chemotherapy is associated with cognitive changes. Year: 2003 Abstract No: 47 Author(s): D. H. Silverman, S. A. Castellon, L. Abraham, C. J. Dy, B. S. Pio, P. A. Ganz; David Geffen School of Medicine at UCLA, UCLA School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, CA Abstract: Cognitive impairment has been reported in association with adjuvant chemotherapy in breast cancer survivors (BCS), but the etiology is unknown. We studied regional cerebral metabolism in BCS recruited from an earlier study of women in whom we had found significant neurocognitive changes associated with adjuvant chemotherapy, including deficits on the California Verbal Learning Test (CVLT, list B). Twelve women (51+/-6 y.o., 16+/-3 yrs formal education, mean +/- SD) underwent repeat neuropsychologic testing within four days of brain positron emission tomography with F-18 fluorodeoxyglucose; 4 had previously received adjuvant chemotherapy plus tamoxifen, 4 had received adjuvant chemotherapy alone, and 4 had received no chemotherapy (2 BCS and 2 healthy controls). Scans were acquired while subjects rested quietly in a dimly lit room. Brain metabolic activity was assessed in each of 26 regions, normalized to whole brain activity levels for each subject, and compared with reference ranges previously established in our laboratory in neuropsychologically normal volunteers. In the 8 chemotherapy-treated subjects (but not 4 untreated subjects) the superior frontal gyrus of the dorsolateral prefrontal cortex, and Broca's area with its contralateral counterpart, showed significant abnormalities in activity relative to the normal reference group after statistical adjustment for multiple comparisons (9% below normal, p<0.001, in each region). The hypometabolism tended to be more severe in the chemotherapy patients who had also received tamoxifen than among those who received chemotherapy only (10-11% vs. 7-8%). Among chemotherapy treated subjects, the most significant correlation between CVLT Z scores and regional metabolism also occurred in the (contralateral) Broca's region (r = -0.79, p<0.02). We believe this represents the first report of such hypometabolism associated with cognitive impairment in BCS. Recruitment to this study is continuing and results will be updated at the presentation, along with results of a memory activation task performed by each subject. Support: Breast Cancer Research Foundation. Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.