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Open Access Highly Accessed Open Badges Research article

Altered small-world properties of gray matter networks in breast cancer

S M Hadi Hosseini1, Della Koovakkattu1 and Shelli R Kesler12*

Author affiliations

1 Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, MC5795, Stanford, CA, 94305-5795, USA

2 Stanford Cancer Center, Palo Alto, CA, 94304, USA

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Citation and License

BMC Neurology 2012, 12:28  doi:10.1186/1471-2377-12-28

Published: 28 May 2012



Breast cancer survivors, particularly those treated with chemotherapy, are at significantly increased risk for long-term cognitive and neurobiologic impairments. These deficits tend to involve skills that are subserved by distributed brain networks. Additionally, neuroimaging studies have shown a diffuse pattern of brain structure changes in chemotherapy-treated breast cancer survivors that might impact large-scale brain networks.


We therefore applied graph theoretical analysis to compare the gray matter structural networks of female breast cancer survivors with a history of chemotherapy treatment and healthy age and education matched female controls.


Results revealed reduced clustering coefficient and small-world index in the brain network of the breast cancer patients across a range of network densities. In addition, the network of the breast cancer group had less highly interactive nodes and reduced degree/centrality in the frontotemporal regions compared to controls, which may help explain the common impairments of memory and executive functioning among these patients.


These results suggest that breast cancer and chemotherapy may decrease regional connectivity as well as global network organization and integration, reducing efficiency of the network. To our knowledge, this is the first report of altered large-scale brain networks associated with breast cancer and chemotherapy.