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Breast cancer patients should receive brain scans

Friday September 18th 2020

Women with breast cancer should receive brain scans to ensure metastatic disease is identified while it is asymptomatic, according to a new analysis.

German researchers say early detection of metastatic disease in the brain could deliver significantly improved outcomes for patients.

The researchers, presenting at the 12th European Breast Cancer Conference, say their findings warrant a clinical trial of brain scans for breast cancer patients who are at high risk for developing brain metastases.

This would be in line with patients with other forms of cancer that can spread to the brain, such as lung cancer, who are given a brain scan when they are first diagnosed, they say.

Dr Elena Laakmann, of the University Medical Centre Hamburg-Eppendorf, Germany, said: “The prognosis for patients with breast cancer that has spread to the brain is poor, and survival for these women hasn’t improved over the last few decades. We do not currently test for asymptomatic brain metastases in breast cancer patients, although this does happen in some other types of cancer.

“In this study we wanted to find out more about breast cancer that has spread to the brain and in particular to see whether there might be any advantage to spotting brain metastases before the development of neurological symptoms.”

The researchers examined 2,589 German patients who were diagnosed with breast cancer that had already spread to their brains between 2000 and 2019.

Of these, 2,009 patients had already experienced symptoms of brain metastases, while the remaining 580 women had no symptoms of brain metastases and were diagnosed by chance.

The researchers found that the women who were asymptomatic were generally fitter and had fewer and smaller tumours in their brains.

They also found that women who were diagnosed with brain metastases before symptoms had developed tended to have less aggressive treatments and to live longer – an average of 10.4 months compared to 6.9 months.

The average survival rate for patients with HER2-positive breast cancer without symptoms was 15.2 months, compared to 11.5 months for women with symptoms.

Dr Laakmann said: “Overall, these results suggest that women may be better off if their brain metastases are diagnosed before they begin to cause symptoms. It could be that the asymptomatic women are being diagnosed at an earlier stage, which we would expect to increase survival time, the smaller size and number of brain metastases could also be factors.

“We now need to carry out a clinical trial to see what happens if we screen high-risk breast cancer patients for brain metastases. This will verify whether doing so could increase survival, symptom control or quality of life.”

Tags: Cancer | Europe | Women's Health & Gynaecology

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