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Old 09-28-2015, 09:14 AM   #16
agness
Senior Member
 
Join Date: Aug 2014
Location: Seattle, WA
Posts: 285
Re: Compiling Data on HER2 Brain Mets

" surgical resection of parenchymal cerebellar metastases has purportedly resulted in subsequent development of LM. Resection of a supratentorial brain metastasis that violates the ventricular system also appears to increase the risks of developing LM"

"isolated meningeal involvement is no longer an exceptional site of relapse after chemotherapy for breast cancer, particularly when taxanes or trastuzumab are used, both of which penetrate poorly into the CSF"

"LM involvement is remains a relatively rare manifestation of HER2/neu positive tumors (3-5%) notwithstanding the observed increased incidence of parenchymal 2].[37,73,157,160,227] In breast cancer, the most common solid tumor to cause LM, risk factors of LM include an infiltrating lobular carcinoma and cancers negative for estrogen receptor (ER) and progesterone receptor (PR).[4,169–171,177,108,181] Triple negative status of breast cancer (HER2/neu negative; ER negative; PR negative) has been reported to be a risk factor of LM.[230] LM involvement is remains a relatively rare manifestation of HER2/neu positive tumors (3-5%) notwithstanding the observed increased incidence of parenchymal brain metastasis."

"the incidence of undiagnosed or asymptomatic LM may be 20% or more with many solid tumors as illustrated in autopsy series."

"An early diagnosis of LM, before fixed neurologic deficits are manifest, permits earlier and potentially more effective treatment, thus leading to a better quality of life in patients so affected"

Carcinomatous meningitis: Leptomeningeal metastases in solid tumors
http://www.ncbi.nlm.nih.gov/pmc/arti...tid836011title
__________________
  • 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.
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