Brain mets/scar tissue
 

My doctors are not positive that I have a reoccurance but it looks that way. The scar tissue has increased in just 8 weeks since my last brain MRI. I am going to have a brain PET and another type of brain MRI. The RT oncologist recommended not to do gamma knife again because it will lead to more scar tissue. Instead he feels I should have another craniotomy to remove the scar tissue and possible brain tumor. Has anyone been down this road before or is familar?

Hi Sue

Sorry to hear about possibly having to go through more surgery for those brain mets. My mom has had brain mets previously treated by WBR and then a new one about 1cm grew this summer, but has remained stable so far so we are just playing the waiting game with MRIs every 3 months unless she becomes symptomatic. How did you know it might be scar tissue, does it say that on your report??? You mentioned you had a crainectomy, was that bad??? Hopefully it is just scar tissue and you don't have to go through more surgery. Did the MRI show any enhancement on the new enlarged scar tissue??
Hugs, Kristin

brain mets/ scar tissue
 

Hi,
The brain MRI has shown that the lesion has grown but it could be scar tissue. It is hard to tell w/o a biopsy. My Dr. would like to have a craniotomy so that we remove the scar tissue and not take any chances. I have been NED elsewhere for over 5 years but continue to fight brain mets. I am to get a brain PET and a brain MRI with profusion next week. Cancer sucks!

Sue
Usually after Gamaknife the treatment can look like a cancer, but may actually be a dying tumor. Necrotic dead cells are difficult to dx as cancer since it resembles a tumor, but does it act like a cancer. What I mean is , is it growing fast or slowly in millimeters. It may be too soon to make a determination since the radiation can still be working. In my case I had a 1.8 cm treated with GammaKnife and WBRads, and it stopped growing and died after 6 months. Your treatment may still be working. According to my Rad Onc Mri/mrs can help to see what's going on after wards. PET scans for Brain is not recommended for Brain, but rather for soft tissue. Look into getting another opinion before getting a 3rd craniotomy. I went to a wellknown Neurosurgeon at Cedar Sinai in L.A. He told me to wait it out, and the tx may work in a few more months. I learned to have cognitive patience. Having patience in this condition isn't easy. If the tumor gets over 3cm it will be time to take action. Are you taking herceptinall during this time? i DID AND STILL DO. We sometime have an advantage when the blood brain barrier leaks from dema, and herceptin can work its way in. I haven't had problems and a recurrence for 4 yrs. I have been on herceptin for over 6 yrs.
My best well-wishes to you. If you need to talk with me, email me your TEL#.
cHRISTINE@HER2SUPPORT.ORG.

Just curious????
 

Hi, Sue,

First, sorry to learn about this news..but stay strong and positive...look at HOW many girls on this site have come through so much. Also, I just finished working with a woman with even glioblastoma multiforme and she is doing amazingly well...the technology has improved so much and is getting better every day. The lady with GM that I mentioned was treated at Duke University and has nothing but the most positive things to say about her experience. I am sure you can handle whatever comes your way.

Now, my question to you is simply this: At any time during your previous treatments did you ever take Cisplatin or carboplatin??? The reason I ask is just anecdotal and there is really NO HARD core evidence to support it, but I have noticed a slightly higher percentage of brain mets involvement in her-2 patients who have at some point been treated with either of these two drugs--either at the primary tumor stage or during mets??? Like I said, it would be interesting to know if you ever took either one, and if so, there might be something safe we could try to give you a slight edge....

Take care and best of luck, Gina

brain mets/ scar tissue
 

Hi,
My orginal brain met from 10/04 was 5mm which I had gamma knife. The lesion or scar tissue is now 1.3 cm by 2 cm. We have been watching it and it has grown in just 8 weeks. The brain PET is to look uptake to gain more information on whether or not it is a reoccurance. The brain MRI w/ profusion is to gain more information as well. The main concern is that it is growing. After all the tests are completed I will go to my neurosurgeon for his opinion. So far I have 3 opinions from RT oncologist and they are puzzled but lean towards it being brain mets. I can go to any NYC doctors you may want to recommend?

When I was orginally diagnosed 5.5 years ago with primary bc I was on A/C and Taxol. I now take Femara and Lupron shots and Herceptin every 3 weeks. I have been doing this for one year. I have always been NED throughout my body. This saga never seems to end although I am still here God willing.

PET for brain
 

Just had this conversation with my med onc 2 weeks ago.
My large tumor (3cm) that was Gamma Knifed in Jan is still showing only some shrinkage. The shape is not the same, but the area is still quite visible.

He said as long as it did not change by growing larger, we can assume that the treatment worked. If it did begin to grow a PET of the brain could help tell us what is going on. The glucose uptake would be more than the normal uptake in the surrounding tissue if it were active disease. Inflammation looks different than the tumor or necrotic tissue, and would also show uptake and would be an indication of active tumor.

I say get all the tests you can before deciding. But the idea of removing the scar tissue and getting a biopsy seems reasonable to me.

Wishing you guidance and peace.

brain mets/ scar tissue
 

My oncologist basically said the same thing your oncologist said. Monday and Tuesday I get these test done and then meet with my neurosurgeon on Wednesday, I should have everyones opinion by next week. My neurosurgeon has told me in the past the only sure way is a biopsy. The doctors feel that because I have been NED elsewhere for over 5 years why take a chance? I am not so keen on having any more invasive surgery so I am in mimbo and waiting for next week to be over!!