Complex breast cancer (BC) treatment can cause various neurological and psychiatric complications, such as postmastectomy pain syndrome, vestibulocerebellar ataxia, and depression, which can lead to microstructural damage of the white matter tracts of the brain. The purpose of the study is to assess microstructural changes in the white matter tracts of the brain in BC survivors using diffusion tensor imaging (DTI). Single DTI scans were performed on patients (n = 84) after complex BC treatment (i.e., surgery, chemotherapy and/or radiation therapy) and on the control group (n = 40). According to the results, a decrease in the quantitative anisotropy (FDR ≤ 0.05) was revealed in the bilateral corticospinal tracts, cerebellar tracts, corpus callosum, fornix, left superior corticostriatal and left corticopontine parietal in patients after BC treatment in comparison to the control group. A decrease in the quantitative anisotropy (FDR ≤ 0.05) was also revealed in the corpus callosum and right cerebellar tracts in patients after BC treatment with the presence of postmastectomy pain syndrome and vestibulocerebellar ataxia. The use of DTI in patients after BC treatment reveals microstructural properties of the white matter tracts in the brain. The results will allow for the improvement of treatment and rehabilitation approaches in patients receiving treatment for breast cancer.
The article is devoted to one of the manifestations of post-mastectomy syndrome - cerebrovascular disorders that develop in patients after radical treatment of breast cancer. The literature review considers the pathogenetic aspects of cerebrovascular disorders, clinical manifestations, methods of diagnosis and treatment of this pathology.
Damage to the peripheral nervous system (PNS) is a common complication of breast cancer (BC) treatment, with 60 to 80% of breast cancer survivors experiencing symptoms of PNS damage. In the current study, the levels of brain-derived neurotrophic factor (BDNF), galectin-3 (Gal-3), and neurotrophin-3 (NT-3) were measured in the blood serum of BC patients by ELISA as potential biomarkers that might indicate the PNS damage. Sixty-seven patients were enrolled in this multi-center trial and compared to the aged-matched healthy female volunteers (control group) (n = 25). Intergroup comparison of biomarker levels (i.e., Gal-3 and BDNF) did not show significant differences in any of the studied subgroups. However, intriguingly, NT-3 levels were significantly higher in BC patients as compared to healthy volunteers, constituting 14.85 [10.3; 18.0] and 5.74 [4.56; 13.7] pg/mL, respectively (p < 0.001). In conclusion, NT-3 might be employed as a potential biomarker in BC patients with clinical manifestations of PNS damage. However, further studies to validate its correlation to the degree of peripheral nervous system lesions are of high value.
Background. In recent years, the prognosis of survival after treatment for breast cancer (BC) has improved significantly, leading to an increase in the life expectancy of patients and the incidence of long-term side effects of therapy. reducing the risks of complications and developing a unified algorithm for diagnosing cerebral complications are necessary to improve the quality of life of patients.Objective. To correlate the CNS and endothelium damage biomarkers concentration and the functional connectivity of the brain in patients with newly diagnosed vestibulo-atactic syndrome (VAS) and without it in the late period of radical treatment of breast cancer.Design and methods. The study involved 21 patients with VAS in the late postoperative period after radical treatment of breast cancer, as well as a group of healthy volunteers — 17 people. Biomarkers were determined by ELISA. Functional MRI was performed.Results. An increase in markers of CNS damage and endothelial damage (ICAM, PECAM) was noted in patients with post-mastectomy syndrome (PMES) and VAS, compare with control group and PMES without VAS group. The processes of disorganization and the formation and strengthening of interand intrahemispheric connections were noted using fMRI.Conclusion. The development of novel diagnostics methods, including the use of fMRI and the determination of different biomarkers are promising for improvement of the VAS treatment effectiveness in patients with PMES.
Relevance. Currently, neuropsychiatric disorders are considered one of the main ones in the pathogenesis of postmastectomy syndrome. Modern neuroimaging techniques — functional (fMRI) and diffusion tensor (DTI) magnetic resonance imaging — allow us to identify functional and structural changes in the brain connectome in patients with postmastectomy syndrome caused by a complex of neuropsychiatric disorders.The purpose of the study. To evaluate changes in the functional and structural connectome of the brain in patients with postmastectomy syndrome using fMRI and DTI techniques.Materials and methods. The study was carried out on a tomograph with a magnetic field induction of 3.0 T. 46 patients with neurological disorders in the long-term postoperative period (more than 6 months) after radical mastectomy, chemotherapeutic and/or radiation treatment of breast cancer were examined.Results. According to the results of the intergroup statistical analysis, all 46 patients with postmastectomy syndrome had differences in functional connectivity in the default mode network and quantitative fractional anisotropy in the white matter tracts of the brain compared with the control group (p < 0.01).Conclusion. The use of fMRI and DTI in patients with postmastectomy syndrome makes it possible to identify changes in the brain connectome correlating with neurological disorders and a decrease in the quality of life of patients. The results obtained will allow improving treatment and rehabilitation approaches in patients receiving treatment for breast cancer.
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