Information for Participants
What is the purpose of ProBC2?
Our laboratory, as well as others, has demonstrated abnormalities in brain structure and function associated with breast cancer chemotherapy, most consistently in the prefrontal cortex. The prefrontal cortex is critical for skills, such as multi-tasking, attention, processing speed and memory, that are often impaired in patients who have undergone breast cancer chemotherapy.
Because prefrontal cortex changes have also been observed in patients prior to chemotherapy treatment as well as in those treated with radiation and/or hormonal blockade, the specific effects of chemotherapy on prefrontal cortex remain unclear. It is also currently unknown why some patients treated with chemotherapy show improvement in cognitive function over time while others do not.
The proposed research will examine both cognitive functioning and prefrontal cortex structure and function in the brain by using non-invasive brain imaging (MRI) methods in combination with other cognitive tests and questionnaires.
We will also explore possible predictors of individual outcome. Increasing our understanding regarding the neurobiological mechanisms underlying chemotherapy-related cognitive impairments may improve identification of patients at highest risk for cognitive deficit and aid the development of treatments for these impairments.
Relevance
A significant proportion of women who receive chemotherapy for breast cancer will experience long- term problems with brain function, such as thinking, memory and attention that reduce quality of life and extend disease-related disability. The proposed study aims to improve our understanding regarding the brain changes that occur during breast cancer chemotherapy. This research is highly relevant to breast cancer, one of the most common public health problems, affecting 1 in 8 women.
Useful Forms and Links
Who is Eligible for ProBC-2?
If you were a previous participant in our study ProBC, you are likely eligible for ProBC2
Inclusion Criteria:
Previous ProBC participants
Exclusion Criteria:
Any contraindications to MRI scanning such as: pacemakers, certain metal implants, severe claustrophobia, pregnancy
What is the purpose of PAC-AI?
Chemotherapy-related cognitive impairment (CRCI) affects an estimated 60% of patients, negatively impacting quality of life. Currently, there is no established method for predicting which patients will develop CRCI. This information could be practice-changing by assisting clinicians with treatment decision-making for individual patients.
We have shown that the brain network (“connectome”) is significantly altered in patients with CRCI. In an earlier study, we measured the connectome in patients prior to any treatment and showed that these brain network properties could be used in combination with machine learning to predict 1 year post-chemotherapy cognitive impairment with 100% accuracy.
The proposed project aims to test this prediction model in a new, larger sample with the overarching goal of validating its use for clinical practice. We will enroll 100 newly diagnosed patients with primary breast cancer scheduled for adjuvant chemotherapy who will be assessed prior to any treatment, including surgery with general anesthesia, 1 month after chemotherapy treatment and again 1 year later. We will also enroll matched healthy female controls who will be assessed at the same time points.
Data from healthy controls will be used to determine impairment status in patients with breast cancer and to provide a template of typical connectome organization for comparison.
We hypothesize that our machine learning model will accurately predict 1 year post- chemotherapy cognitive impairment and that it will be more accurate than a model that includes patient history and medical information alone. We will also examine the changes in brain networks over time. This information will provide novel insights regarding the neural mechanisms of CRCI and may also help us refine our prediction models.
Relevance
A significant proportion of women who receive chemotherapy for breast cancer will experience long- term problems with brain function, such as thinking, memory and attention that reduce quality of life and extend disease-related disability. The proposed study aims to validate a model for predicting who will develop long-term cognitive impairment and to examine the underlying causes of this impairment. This research is highly relevant to breast cancer, one of the most common public health problems, affecting 1 in 8 women.
Useful Forms and Links
Who Is Eligible for PAC-AI?
If you are a female with newly diagnosed breast cancer and you have not yet received any chemotherapy or radiation treatment, or have completed chemotherapy at least one month ago, you may be eligible for PAC-AI.
Inclusion Criteria for Newly Diagnosed Breast Cancer Patients:
- Female with newly diagnosed breast cancer
- Have not started chemotherapy or radiation treatment
- Are age 35-68 years old
- Scheduled for chemotherapy
Exclusion Criteria for Newly Diagnosed Breast Cancer Patients:
- Have begun chemotherapy or radiation treatment for breast cancer diagnosis
- Currently pregnant
- History of neurologic or psychiatric conditions or cancers unrelated to BC
- Other major medical conditions that would lead to unstable health
- Any contraindications to MRI such as: Pacemakers, certain metal implants, severe claustrophobia, pregnancy
Inclusion Criteria for Survivors:
- Female breast cancer survivors
- Have completed chemotherapy at least one month ago
- Aged 35-68 years old
Exclusion Criteria for Survivors:
- Currently pregnant
- History of neurologic or psychiatric conditions or cancers unrelated to BC
- Other major medical conditions that would lead to unstable health
- Any contraindications to MRI such as: Pacemakers, certain metal implants, severe claustrophobia, pregnancy