What should you know about TNBC metastasis to the brain?

Brain metastasis means cancer cells from the breast have reached the brain. Symptoms depend on the area affected and may include headache, nausea, seizures, weakness, numbness, balance problems, speech changes, vision changes, confusion, or altered behaviour. Some people have no symptoms, so scans may be used when the clinical team has a reason to investigate.

Assessment commonly includes a neurological examination and brain imaging, often with contrast. Doctors also consider the number, size, and position of lesions, swelling around them, symptoms, overall cancer pattern, and previous treatments. These details guide whether surgery, focused radiation, whole-brain radiation, medicines for swelling or seizures, systemic treatment, or a combination is appropriate.

Tell the oncology team about any new neurological symptom, even if it comes and goes. Bring a medicine list and note when symptoms began, what makes them worse, and whether they affect walking, speaking, eating, or self-care. Do not drive if a seizure, fainting episode, severe dizziness, or sudden visual problem has occurred unless your clinician says it is safe.

Ask how brain-directed treatment fits with treatment for cancer elsewhere in the body. Chemotherapy, immunotherapy, or PARP inhibitor therapy may be discussed according to tumour features, prior treatment, and general health.

Call emergency services for a first seizure, a seizure that does not stop, sudden one-sided weakness, new difficulty speaking, loss of consciousness, severe confusion, or a sudden severe headache with vomiting. Contact your oncology team promptly for a steadily worsening headache, repeated vomiting, increasing sleepiness, or new balance or vision problems.

What did the brain scan show, and is swelling present? Which treatment is intended to control the brain lesions? How could treatment affect memory, hair, energy, or daily activities? What symptoms should trigger an emergency call?