Brief Answer:
Everything is indeed ok.

Detailed Answer:
I read your query and I understand your concern. Often patients become worried after reading that sort of report and need reassurance.

I am assuming by "everything is ok" in the medication field you mean that it is what your doctor said not recommending any treatment.

Human brain like other systems does undergo its changes with age. Those include reduction in its volume and some degree of narrowing of small blood vessels. So when we interpret MRI findings related to these changes, we must take into account also the age of the patients in order to understand whether the findings are normal for that age or if they are premature and some abnormality is to be sought when the changes appear at a very young age.

In your case considering your age it is expected to have some mild volume loss (the "mild cerebral and cerebellum volume loss" part of the report), as well as some changes in the cerebral white matter due to narrowing of small blood vessels and lack of blood supply in the furthest areas ( the "few small scattered foci of increased signal on T2-weighted imaging in the cerebral white matter" part of the report). At times the scattered foci could be also nonspecific gliotic changes, old remnants of some other type of brain involvement in the past like infection, but that would be again a change belonging to the past which you might have had for many years and won't evolve.

Only if the volume loss had been marked and the white matter changes extensive with accompanying changes in memory and other cognitive functions would it have been considered abnormal and a possible cause for dementia.

So the only treatment recommended is paying attention to conditions which predispose to blood vessel disease like high blood pressure, diabetes, smoking, high cholesterol, obesity, lack of physical activity and addressing them if present.

I hope to have been of help.

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Brief Answer:
Not likely from chemo, but can't exclude

Detailed Answer:
That is a good point that you make.

First of all, even if atrophy is a little more than usual for your age, unless you have any symptoms it doesn't necessarily mean much. Studies have shown there is not an exact correlation between volume on imaging and higher mental functions. What is for sure is that we all lose some brain mass each year, but there are differences between individuals (as with other features of ageing) and the norm is more of an average rather than an exact figure. So, MRI imaging is done to support a hypothetical diagnosis, it never makes a diagnosis in the absence of clinical signs or changes in cognitive function tests.

As for the chemo effects, some chemo drugs are thought to cause brain atrophy, but usually reversible and the regimens used usually for that type of breast cancer have not been linked with brain atrophy. New side effects are found at times in individual patients though, tough to totally rule out, but unlikely.

I hope to have been of help.

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Brief Answer:
Thank you as well!

Detailed Answer:
Thank you as well for choosing Healthcaremagic for your health related questions.

I would be happy to answer any other follow up question you might have. If or when on the other hand you feel that you have no further questions, I would kindly ask you to close the query.

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