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Because distress screening in survivorship relies almost exclusively on self-report, the neural mechanisms shaping how chemotherapy-exposed survivors perceive and report emotional experience remain poorly understood, limiting mechanism-informed psychosocial support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Forty female breast cancer survivors (27 chemotherapy-treated, 13 non-chemotherapy) and 30 age-matched healthy controls completed a validated face-word emotional Stroop task during functional MRI to probe emotional attention and conflict regulation. Standardized cognitive and affective questionnaires were aggregated into composite indices characterizing each survivor\u2019s neurobehavioral profile.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Chemotherapy-treated survivors showed poorer Stroop accuracy for faces normatively categorized as fearful and hypoactivation of the dorsomedial prefrontal cortex, yet reported lower affective symptoms than non-chemotherapy survivors, who instead showed heightened negative attentional bias and greater incongruency-related interference in the parahippocampal gyrus and insula. A normative inverse coupling between dorsal anterior cingulate cortex activation and affective symptom severity was present only in healthy controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Breast cancer survivors exhibit distinct neurobehavioral phenotypes with potential supportive care implications. Lower self-reported distress in chemotherapy-treated survivors paralleled reduced salience network engagement, a configuration compatible with emotional blunting rather than genuine well-being; because emotional blunting was not measured directly, this remains an interpretive hypothesis. These findings caution against relying solely on self-report screening and motivate the hypothesis that treatment-history-informed survivorship care may be beneficial\u2014affective re-engagement strategies for chemotherapy-exposed survivors, and attention-bias modification or mindfulness-based approaches for non-chemotherapy survivors\u2014a proposal that now requires testing in intervention trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00520-026-11271-z","type":"journal-article","created":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T13:56:54Z","timestamp":1790949414000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Distinct affective neural phenotypes in breast cancer survivors: implications for personalized supportive care after chemotherapy"],"prefix":"10.1007","volume":"34","author":[{"given":"Chenyi","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao-Jin","family":"Chiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Chun","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang-Teng","family":"Fan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsai-Tsen","family":"Liao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chin-Yau","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yawei","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,2]]},"reference":[{"issue":"8","key":"11271_CR1","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1016\/j.tics.2013.06.009","volume":"17","author":"EM Aminoff","year":"2013","unstructured":"Aminoff EM, Kveraga K, Bar M (2013) The role of the parahippocampal cortex in cognition. 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