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Susie,
In the case of my sister, she had whole brain radiation to treat 3 smaller remaining lesions after a larger (~3cm x 3cm) was removed(Oct) in her first craniotomy. The WBR almost knocked the smaller lesions out, but then they slowly started to come back. That was when(Mar-Apr) they put her on the Lapatinib trial, hoping that it would stop the Her2 growth activity. Her oncologist said that we all hoped that it would help my sister, but if it didn't, there was always sterotactic surgery, &/or another craniotomy. Two months later the lesions were still growing and she was having headaches, so they took her off the trial. She then had a second craniotomy(May) to remove the 3 lesions. After that she had stereotactic radiation to the 3 cavities.
She had an MRI 8/1 and her neuro-oncologist is happy with what she sees - NED. The rest of my sister's body is clear -- she's on Herceptin every 3 weeks.
I think the doctors' recommendations depend on whether the disease is progressing, whether it's shown up anywhere else in the body, and how large the area of concern (lesion) is. Your MRI notes that while there's "abnormality and enhancement..." there's also "no evidence of mass effect." That sounds to me like it could be an opportune time to see if the Lapatinib can help you.
I hope you have great results with whatever approach you go with.
Marianne
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