A study on the changes of white matter microstructure in breast cancer patients undergoing chemotherapy based on DTI technology

Background Breast cancer is a prevalent cancer affecting women globally, with incidence rates rising rapidly. Purpose To examine the diffusion tensor imaging (DTI) data of patients with breast cancer before and after chemotherapy through tract-based spatial statistical analysis (TBSS). Material and Methods Cognitive and neuropsychological tests and whole-brain DTI were administered to patients with breast cancer who did not receive postoperative chemotherapy (C–) or received postoperative chemotherapy (C+) and healthy controls (HCs). Structural differences across groups were compared through fractional anisotropy (FA), mean diffusivity rate (MD), radial diffusivity tensor (RD), and axial diffusivity tensor (AD). Spearman’s correlation analysis was employed to explore the association of FA, MD, RD, and AD values in different brain regions with the results of cognitive and neuropsychological tests, as well as the relationship between DTI parameters and cognitive performance as measured by the Montreal Cognitive Assessment (MoCA) scores. Results Compared with the C– group, the C + group exhibited significant reduced FA values and increased MD and RD values in the genu of the corpus callosum, bilateral anterior and superior corona radiata, left posterior thalamic radiation, left external capsule, and bilateral superior longitudinal fasciculus. Spearman’s correlation analysis showed a notable association between reduced FA values in specific regions and decreased cognitive performance, as measured by MoCA scores. Conclusion These findings suggest that the alterations in white matter microstructure induced by breast cancer chemotherapy may contribute to cognitive decline. Further research is warranted to strengthen evidence for this relationship.