www.ccsenet.org/ijb International Journal of Biology Vol. 4, No. 2; April 2012 Published by Canadian Center of Science and Education 3 Structural Brain Differences in Breast Cancer Patients Compared to Matched Controls Prior to Chemotherapy Carole Scherling (Corresponding author) University of Ottawa, School of Psychology 136 Jean Jacques Lussier, Vanier Hall, room 2068, Ottawa, ON, K1N6N5 Canada E-mail: csche087@uottawa.ca; cscherling@memory.ucsf.edu Barbara Collins Ottawa Hospital and University of Ottawa 1053 Carling Avenue, Civic Campus, room A603, Ottawa, ON, K1Y4E9, Canada Joyce MacKenzie Ottawa Hospital, 1053 Carling Avenue, Civic Campus, Ottawa, ON, K1Y4E9, Canada Chris Lepage, Catherine Bielajew & Andra Smith University of Ottawa, School of Psychology 136 Jean Jacques Lussier, Vanier Hall, Ottawa, ON, K1N6N5, Canada Received: November 18, 2011 Accepted: December 1, 2011 Published: April 1, 2012 doi:10.5539/ijb.v4n2p3 URL: http://dx.doi.org/10.5539/ijb.v4n2p3 The Canadian Breast Cancer Foundation has funded this project. Abstract Understanding the relationship between chemotherapy and cognitive impairment requires information on pre-treatment variability between cancer patients and well-matched controls. The purpose of this study was to investigate neuroanatomical differences between breast cancer (BC) patients and controls, prior to chemotherapy,controllingfor possible confounding variables. Twenty-three female early-stage BC patients underwent MRI scanning after surgery but before chemotherapy and were sex-, age- and education-matched to non-cancer controls. Whole brain and region of interest (ROI) group comparisons of grey (GM) and white matter (WM) were performed using voxel-based morphometry.Significant ROI structural differences between BC patients and controls were found depending on the type of analysis used and the covariates entered. This is one of the first imaging studies to focus on pre-chemotherapy neuroanatomical differences between BC patients and well-matched controls, considering demographic, psychological and biological factors in the analyses. Results highlight the importance of better understanding the whole patient prior to chemotherapy, stressing the importance of rigorous methodological procedures. Keywords: Cognitive impairment, Magnetic resonance imaging (MRI), Voxel-based morphometry (VBM), Pre-treatment effects, Chemotherapy, Surgery, Neuropsychology, Anatomy 1. Introduction Recent medical advances have greatly improved the odds of achieving long term survival in cancer patients. This has led to increased attention for improving post-treatment quality of life. One factor of particular interest is related to patient self-reports of cognitive impairments following chemotherapy treatment, most often revealed in breast cancer (BC) populations. Patients have coined terms like “chemo fog” and “chemo brain” to refer to these changes that can manifest both during and after treatment. The incidence of chemotherapy-related impairments is