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09-11-2007, 07:47 PM
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#1
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Senior Member
Join Date: Nov 2006
Location: Bedford, Virginia
Posts: 134
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Brain MRI's - Who should get them?
I have seen a lot of threads during the past couple of weeks regarding MRI's of the brain. When does it make sense to get a brain MRI? For example, my tumor was Stage II and no nodes were involved. During the past couple of months I have learned to be more assertive due to this website. I asked for a MRI of my left breast, and I recently asked for some bloodwork due to some itching to eliminate suspecting liver problems. I plan on doing mammos each spring, and MRI of the breast in the fall. I don't know if it is reasonable to ask my Onc to conduct a MRI of the brain or not. I am an optimist by nature, but I don't want to be naive either.
Looking for feedback as I simply don't know. Thanks.
Louise
__________________
- Diagnosis 06/06 - Stage II-A BC; BC was 2.5 cm, grade 2; ER/PR negative & HER-2/neu positive;
- Mastectomy w/ reconstruction (implant) in 09/06;lymph nodes - negative;
- AC/Cytoxin combo - 4 treatments (dose dense);
- Taxol/Herceptin combo- 12 weekly treatments;
- Completed chemo - 2/07; completed restruction 02/07; reduction of left breast.
- BRCA 1 and 2 negative - 6/15/07;DX high risk for distant recurrence
- MRI, 08/02/07 - NED
- 1 year Anniversary - 09/07; completed Herceptin 11/07.
- Mammo 02/14/08 - NED; MRI - 08/2008 - NED
- 2 year Anniversary - 09/08
- Mammo 02/09 - NED; MRI - 08/09 - NED
- 3rd year Anniversary - 09/09
- 5th Annivery - 09/2011 - NED
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09-11-2007, 11:07 PM
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#2
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Senior Member
Join Date: Feb 2006
Location: Acworth, GA
Posts: 2,104
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With HER2 breast cancer it is recommended that you have a brain MRI once a year. This is because this cancer likes to metastise to the brain and Herceptin does not cross the brain blood barrier. My brain met was found on my yearly brain MRI -- I had no symptoms. Now since I had a brain met I will be getting brain MRIs every 3 months.
__________________
Kate
Stage IIIC Diagnosed Oct 25, 2005 (age 58)
ER/PR-, HER2+++, grade 3, Ploidy/DNA index: Aneuploid/1.61, S-phase: 24.2%
Neoadjunct chemo: 4 A/C; 4 Taxatore
Bilateral mastectomy June 8, 2006
14 of 26 nodes positive
Herceptin June 22, 2006 - April 20, 2007
Radiation (X35) July 24-September 11, 2006
BRCA1/BRCA2 negative
Stage IV lung mets July 13, 2007 - TCH
Single brain met - August 6, 2007 -CyberKnife
Oct 2007 - clear brain MRI and lung mets shrinking.
March 2008 lung met progression, brain still clear - begin Tykerb/Xeloda/Ixempra
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09-12-2007, 08:27 AM
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#3
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Senior Member
Join Date: Aug 2006
Posts: 492
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From what I understand, if you have other mets, you should be getting regular brain MRIs. If you have node + her2+ local disease, it is not unreasonable to want one, but is not standard protocol. Since her2+ can set up shop in the brain first, although this is not likely, and this is the most important time to catch anything in it's infancy- I requested a brain MRI last year, even though I am Stage 3. My onc asked if I was having headaches or dizziness. I said no. He said "Marge, are you having headaches or dizziness?" and gave me the look. You know, you have to report something to the insurance, bless his heart.
My MRI was "unremarkable". Didn't mind not attracting attention to my self then. Now I am up for renewal, so to speak. The flip side is every little headache, light headedness (getting off the massage table yesterday) you have brain met club in the back of your mind. I am hoping for another unremarkable brain mri. Then I will be 2 years out and I think I will not continue these unless I have defiite symptoms.
__________________
Are we there yet?
Dx 10/05 IDC, multi-focal, triple +, 5 nodes+
MRM, 4 DD A/C, 12 weekly taxol + herceptin
rads concurrent with taxol/herceptin
finished herceptin 01/08
ooph, Arimidex, bilateral DIEP reconstruction
NED
Univ. of WA, Seattle vaccine trial '07
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09-13-2007, 08:54 AM
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#4
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Senior Member
Join Date: May 2006
Posts: 144
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Hi Kate,
Is there any reference to your statement that brain MRIs are recommend for her2+ women? My onc. said she'd only order a brain MRI if I have symptoms, even though I pointed out that her2+ women are more likely to have brain mets.
- Anna
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- Anna
Stage I - DX 9/2005 ER/PR-, HER2+, grade 3, DCIS, IDC multi-focal (1.05cm)
DD 4 A/C finished Jan 31, 2006
Herceptin weekly finished Jan 31, 2007
recurrence to chest wall on last month of Herceptin
Stage 3B - 3/15/07 - 2 carcinomas in dermal lymphatic
Rads finished 6/5/07
12x TH finished 9/10/07
12/07 - Clear scan!
3/08 - 4 month Melatonin trial
1/09 - osteoperosis - start Alendronate
2/09 - 4-month Simivastin trial
3/13 - take drug holiday after 5 years of Alendronate
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09-13-2007, 12:47 PM
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#5
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Senior Member
Join Date: Nov 2006
Location: Bedford, Virginia
Posts: 134
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Kate/Margerie, thank you both for your responses. I copied and pasted the entire thread and sent it to my Oncologist. He is young so he has a higher tolerance than some physicians! I told him we can discuss it at our next appointment which is not until Oct 3.
Margerie, I had to chuckled about your headaches... Some times we have to manage out health care ourselves.
Thanks again.
Louise
__________________
- Diagnosis 06/06 - Stage II-A BC; BC was 2.5 cm, grade 2; ER/PR negative & HER-2/neu positive;
- Mastectomy w/ reconstruction (implant) in 09/06;lymph nodes - negative;
- AC/Cytoxin combo - 4 treatments (dose dense);
- Taxol/Herceptin combo- 12 weekly treatments;
- Completed chemo - 2/07; completed restruction 02/07; reduction of left breast.
- BRCA 1 and 2 negative - 6/15/07;DX high risk for distant recurrence
- MRI, 08/02/07 - NED
- 1 year Anniversary - 09/07; completed Herceptin 11/07.
- Mammo 02/14/08 - NED; MRI - 08/2008 - NED
- 2 year Anniversary - 09/08
- Mammo 02/09 - NED; MRI - 08/09 - NED
- 3rd year Anniversary - 09/09
- 5th Annivery - 09/2011 - NED
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09-14-2007, 03:50 PM
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#6
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Senior Member
Join Date: Aug 2001
Location: Oregon
Posts: 1,756
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Anna, here's a link to an article posted on this site in the Brain Metastasis section. You can find the section by going to the Home page and scrolling through the index.
Brain Metastasis: The HER2 Paradigm
http://her2support.org/temp/winer.pdf
__________________
Sept.'99 - Dx.Stage IIIB, IDC ER/PR-, HER2+++ by IHC, confirmed '04 by FISH. Left MRM, AC x's 4, Taxol x's 4, 33 Rads, finishing Tx May 2000. Jan.'01 - local/regional recurrence, Stage IV. Herceptin/Navelbine weekly till NED August 2001, then maintenance Herceptin. Right Mast. April 2002. Local/Regional recurrence April '04, Herceptin plus/minus chemo until May '07. Gemzar added from Feb.'07-April '07; Tykerb/Abraxane until August '07, back on Herceptin plus Taxotere and Xeloda Sept. '07. Stopped T/X Nov. '07, stopped Herceptin Dec. '07, started Avastin/Taxol/Carboplatin Dec. '07. Progression in chest skin, stopped TAC March '03, started radiation.
Herceptin has served as the "Backbone" of my treatment strategy for over 6 years, giving me great quality of life. In 2005, I was privileged to participate in the University of Washington/Seattle HER2 Vaccine Trial.
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