CNS Metastases in HER2-Positive Breast Cancer with Asymptomatic or Oligosymptomatic Brain Involvement
Brain metastases in patients with HER2-positive breast cancer can present with minimal or no neurological symptoms. When general status is preserved and brain involvement is asymptomatic or oligosymptomatic, management decisions differ from those for symptomatic or large-burden disease — and a structured, evidence-based approach guides the appropriate next step.
Clinical Scenario
HER2-positive breast cancer with asymptomatic or oligosymptomatic brain metastasis and preserved general status. In this population, systemic treatment is a key consideration in the overall management strategy.
Management Approach — Partial Overview
On progression, cases are reviewed at a multidisciplinary board. The approach may involve a localised or systemic intervention — the complete structured regimen, including sequencing and individualised options, is available via the full protocol.
References
DOI: 10.1016/j.annonc.2021.07.016
- Systemic treatment of asymptomatic or oligosymptomatic BMs should be considered to delay WBRT in HER2-positive breast cancer patients with a preserved general status.
- On an individual case-by-case consideration, surgery, (repeat) SRS, change of systemic treatment and combinations thereof may be considered.
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