[chrisy]

Please don't read me wrong - Dr Rugo has not recommended brain MRI as routine screening!

Brain MRI's are not standard protocol or even recommended for early stage BC, although if you develop symptoms you should request this. Ladies with Her2+++ need to be vigilant, and aware of the symptoms. If you are getting a full set of tests (CT etc) just once to verify no mets, I'd try to get an MRI included at that time as well - my opinion only. But even that (CT) is by no means standard protocol if there is no node involvement.

For advanced (metastatic) Her2+++ BC, Dr. Rugo has not suggested that I get frequent scans on a routine basis, but has a VERY low threshold for me getting one if there are any symptoms, because early detection is important. So in her opinion, basically, if there are NO symptoms at all, it isn't necessary to get repeated scans just for screening purposes. I asked her this specific question last year (should I get regular screening) and she said no, adding that if I have a clean scan then a month later have symptoms, nobody will want to scan me again so soon! Don't know if she meant doctors, insurers, or both. But as she DOES NOT RECOMMEND ROUTINE SCREENING for me, I feel pretty sure she also would not advocate this for early stagers, either.

I had a scan in July 2005 because I was having sinus-like headaches. I was confirmed to be a bubblehead (nothin in there!) then. It's been 18 months since then, I still have intermittent headaches with no other symptoms but she felt it was time to have another look just to be on the safe side.

Again, this is all recommendations that were directed specifically to me, everyone is different.

I think with early stage BC you do have to be aware and vigilant, but balance that with the knowledge that it is EARLY stage with good prognosis (especially with adjuvant herceptin which was not available to me). It's hard not to be paranoid but you can't live your life in fear either.

Chris