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My sister had a 2.3cm tumor in rt breast diagnosed in May '03, lumpectomy 7/03 no positive nodes, started AC chemo 8/03, Taxol started 12/03, mets to right breast diagnosed 1/04, rt brst mastectomy 2/04, Herceptin started 3/04, radiation 3-4/04, headaches 9/04 diagnosed by MRI as brain mets, 1 golf ball sized brain met removed in craniotomy 10/04, whole-brain-radiation 11/04, extreme extreme fatigue from WBR from 12/04-3/05, Lapatinib (Tykerb) trial 2/05-3/05 but brain mets still grew, second craniotomy 5/05 removed 3 med. size mets, stereotactic radiation to tumor beds by gamma knife 6/05. My sister just this past Monday had her third session of CyberKnife radiation treatment to 4 new small mets -- I think the WBR has minimized the number of mets that grow, but new ones do keep showing up. Give her experience of a relatively small tumor w/no positive nodes at diagnosis, I would recommend starting on Herceptin immediately to get the tumor cells in the body and before they reach the brain, because the blood/brain barrier prevents Herceptin from entering and stopping brain metastasis. Tykerb helps some people, but not all.
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