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Old 01-18-2016, 03:23 PM   #53
agness
Senior Member
 
Join Date: Aug 2014
Location: Seattle, WA
Posts: 285
Re: Compiling Data on HER2 Brain Mets

"It is estimated that 10-35% of patients diagnosed with breast cancer will develop metastasis to the brain. Although patients with localized disease have a low probability of initial brain metastasis (BM), those with regional and metastatic disease have a 7.6% and 13.5% risk of BM at diagnosis, respectively, while those with HER-2 positive disease or ER-negative disease may be at an even higher risk, especially in the context of other visceral metastases, such as the liver. Current international guidelines for the evaluation of a new patient with breast cancer recommend screening for BM only if there are suspicious clinical symptoms, and not as a routine test. For patients with neurological symptoms, such as progressive headache, motor dysfunction, or sensation changes, there should be a low threshold for ordering an MRI of the brain. Treatment options for breast cancer brain metastases (BCBM) include surgery with/without adjuvant radiotherapy (whole brain or tumor-bed alone), whole-brain radiotherapy (with or without a focal boost, such as radiosurgery), radiosurgery alone, and potentially, systemic or targeted therapy, either used singly or in conjunction with other localized therapeutic approaches."

Management of solitary and multiple brain metastases from breast cancer (2015)
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4477383/
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  • Dx 2/14 3b HER2+/HR- left breast, left axilla, internal mammary node (behind breast bone). Neoadjuvant TCHP 3/14-7/2. PCR 8/14 LX and SND. 10/21-12/9 Proton therapy to chest wall.
  • Dx 7/20/15 cerebellar met 3.5x5cm HER2+/HR-/GATA3+ 7/23/15 Craniotomy.
  • 7/29/15 bone scan clear. 8/3/15 PET clean scan. LINAC SRS (5 fractions) Sept 2015. 9/17/15 CSF NED, 9/24/15 CSF NED, 11/2/15 CSF NED.
  • 10/27/15 atypical uptake in right cerebellum - inflammation?
  • 12/1/15 Leptomeningeal dx. Starting IT Herceptin.
  • 1/16 - 16 fractions of tomotherapy to cerebellum, break of IT Herceptin during rads, resume at 100 mg weekly
  • 3/2016 - stable scan
  • 5/2016 stable scan
  • 7/2016 pseudoprogression?
  • 9/2016 more LM, start new chemo protocol and IV therapy treatment with HBOT
  • 11/2016 Cyberknife to temporal lobe, HBOT just prior
  • 12/2016 - lesions starting to show shrinkage
  • 8/2017 - Stable since Dec 2016. Temporal lobe lesion gone.
  • Using TCM, naturopathic oncology, physical therapy, chiro, massage, medical qigong, and energetic healing modalities in tandem. Stops at nothing.
  • Mother of 2 boys - ages 7 and 10 (8/2017) and a lovely partner with lots to live for.

Last edited by agness; 01-18-2016 at 03:24 PM.. Reason: cleanup formatting
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