Table 1.

Structural cerebral changes in breast cancer patients prior and after chemotherapy

Assessment	Grey matter changes	White matter changes
Prior to CTx	↔hippocampal volume in BC CTx+ and CTx– [34] ↔density and volume of GM between BC CTx+/CTx–/HC [37, 41, 58] ↔ GM volume in DLPFC and superior parietal cortex between BC CTx+/CTx–/HC [58] ↓ left cingulate GM density in BC CTx– compared to HC [12]	↓ WM volume in frontal, parietal and limbic regions depending on type of analyses and covariates entered [41] ↓WM integrity in BC compared to HC [58]
1–12 months after CTx	↓ prefrontal, parahippocampal, cingulate gyrus, precuneus volume [6] ↓bilateral frontal, temporal (including hippocampus and adjacent medial temporal structures) and cerebellar regions and right thalamus GM density in BC CTx+ than HC [37] ↓left frontal CH density in BC CTx+ compared to HC [12] ↓ frontal, temporal, parietal, and occipital volume [42]	↓ FA in frontal, parietal and occipital tracts after CTx+ [11, 36] ↓prefrontal, parahippocampal, cingulate gyrus, precuneus volume [6]
1–2 years after CTx	↓↑ bilateral superior frontal, left middle frontal, right superior temporal and cerebellar GM density [37] ↓ persisted in bilateral cerebellum, right thalamus and medial temporal lobe, left middle gyrus and right precentral, medial frontal and superior frontal gyri [37] ↓ in bilateral frontal and temporal regions [42] ↓global hippocampal volume in 8% of BCS CTx+ [10] ↓posterior hippocampus in 11% BCS CTx+ compared to HC [10]	↓ FA in genu of corpus callosum in BCS CTx+ than HC [35]
2–10 years after CTx	↔ prefrontal, parahippocampal, cingulate gyrus, precuneus volume between BCS CTx+/CTx–/HC [6] ↓posterior cortical regions and cerebellum volume in BCS HCTx+ compared to CTx– [38] ↓small-world characteristics of GM; altered interactions in frontotemporal regions; fewer network hubs in BCS CTx+ compared to HC [40] ↓left hippocampal volumes in BCS CTx+ compared to HC [13]	↓ white matter integrity BCS HCTx+ compared to CTx– [38]
> 10 years after CTx	↓total brain and GM volume in BSC CTx+ compared to reference group [39]	↔ prevalence of infractions or WM lesions volume in BSC CTx+ than reference group [43] ↑ prevalence of total cerebral microbleeds (CMBs) and CMBs in deep/infratentorial regions in BSC CTx+ than reference group [43]

↔ no changes/no differences; ↓ decrease/smaller; ↑ increase/higher; ↓↑ recovery

CTx+ – cancer patients treated with standard dose of chemotherapy; HCTx+ – cancer patients treated with high-dose chemotherapy;

CTx– – cancer patients without chemotherapy; BC – breast cancer patients; BCS – breast cancer survivors; HC – healthy controls; FA – fractional anisotropy; GM – grey matter; WM – white matter