Breast cancer
Brain metastases in patients with HER2+ breast cancer

Nadine (60 years old)

Nadine, 60 years old, owns a pottery and creates special flower vases. She experiences headache with nausea during the last 2 months which led to a brain CT during the assessment. She was diagnosed with metastatic breast cancer.

  • No relevant medical history
  • Brain CT: multiple suspicious spots
  • Neurological clinical exam: normal
  • PET scan: breast lesion, multiple liver lesions and pleural effusion
  • Brain MRI: 12 brain lesions (all <1 cm, location: sub- and infratentorial)
  • Tumour biology (biopsy breast lesion): ER 0%, PgR 0%, HER2 3+
  • ECOG PS: 0

Which of the following treatment approaches would you choose to treat the brain metastases in this patient?