Cerebral Metastases in Breast Cancer

Abstract

A 52-year-old woman received a diagnosis of stage II hormone-receptor–negative, HER2-positive breast carcinoma (2 of 13 nodes positive). She underwent a left segmental mastectomy, axillary dissection, adjuvant chemotherapy (doxorubicin and cyclophosphamide, followed by cyclophosphamide, methotrexate, and fluorouracil), and local radiotherapy. Two years later, she had recurrent disease with left cervical lymphadenopathy and pulmonary metastases. Her metastatic disease remained well controlled by treatment with trastuzumab and systemic chemotherapy (docetaxel, then vinorelbine). Six years after her initial diagnosis, she presented with headaches and unsteadiness. Four months earlier, computed tomographic (CT) scanning of the brain was normal. Repeated CT and magnetic resonance imaging . . .