Breast Cancer And Brain Metastases: What You Need To Know

Breast Cancer And Brain Metastases: What You Need To Know

This October, during Breast Cancer Awareness Month, it’s vital not only to raise awareness of breast cancer itself but also of the possible complications such as brain metastases. By understanding the risks, symptoms, and treatment options, patients and families can feel empowered to make informed decisions and access the best possible care.

Breast cancer remains one of the most common cancers worldwide, and while many people respond well to treatment, some may face complications if the disease spreads to other parts of the body. One of the more serious developments is brain metastases, where cancer cells travel from the breast to the brain.

This can be a daunting diagnosis, but with advances in treatments, such as targeted therapies and Gamma Knife radiosurgery, the outlook is more positive than ever before.

What are brain metastases in breast cancer?

Brain metastases occur when cancer cells break away from the original breast tumour and travel through the bloodstream or lymphatic system to the brain. Once there, they form new tumours.

Breast cancer is the second most common cause of brain metastases, after lung cancer. Around ten to 15 per cent of people with advanced breast cancer will eventually develop brain metastases, though this figure can be higher in certain subtypes, such as HER2-positive or triple-negative breast cancers.

Who is most at risk of brain metastases in breast cancer?

Not all breast cancer patients will develop brain metastases, but certain factors increase the likelihood. These include:

• Subtype of breast cancer –HER2-positive and triple-negative subtypes are more likely to spread to the brain.
• Stage of cancer – advanced or metastatic disease carries a greater risk.
• Age –younger women with breast cancer may be more prone to developing secondary tumours in the brain.

Understanding these risk factors helps doctors monitor patients more closely, enabling earlier detection and treatment if brain metastases occur.

What are the symptoms of breast cancer brain metastases?

Symptoms depend on the size, number, and location of tumours in the brain. Common signs include:

• Persistent headaches
• Nausea or vomiting
• Seizures
• Vision problems
• Changes in speech, balance, or coordination
• Cognitive or personality changes

Because these symptoms can overlap with other health issues, it’s vital that patients with a history of breast cancer report any new or unusual neurological symptoms to their healthcare team immediately.

How are brain metastases diagnosed?

When brain metastases are suspected, imaging tests are used to confirm their presence. These may include:

• MRI (Magnetic Resonance Imaging) – the most sensitive method for detecting brain metastases.
• CT scans –often used if MRI is not available or suitable.

In some cases, additional tests may be performed to assess the extent of disease and to guide treatment decisions.

What are the treatment options for brain metastases?

Treatment for brain metastases depends on the size, number, and location of tumours, as well as the patient’s overall health and type of breast cancer. Options include:

• Steroids –to reduce swelling and relieve symptoms.
• Surgery –for accessible tumours that can be safely removed.
• Whole-brain radiotherapy (WBRT) –treats the entire brain but can cause side effects such as memory issues.
• Targeted therapies and immunotherapy –newer drugs designed to cross the blood-brain barrier are showing promising results.
• Gamma Knife radiosurgery –a highly precise form of treatment that is becoming increasingly important.

What is Gamma Knife surgery and how does it help?

Despite the name, Gamma Knife surgery is not surgery in the traditional sense. Instead, it is a type of stereotactic radiosurgery (SRS) that uses highly focused beams of radiation to target tumours in the brain with extreme accuracy.

The benefits of Gamma Knife treatment include:

• Precision – only the tumour is targeted, sparing healthy brain tissue.
• Non-invasive –no incision is required, meaning fewer risks and a quicker recovery.
• Effectiveness –often suitable for patients with one or several small brain metastases.
• Convenience – usually performed in a single outpatient session.

For breast cancer patients with brain metastases, Gamma Knife radiosurgery offers an alternative to whole-brain radiotherapy, reducing side effects and improving quality of life while effectively controlling tumour growth.

Can brain metastases be prevented?

Unfortunately, there is no guaranteed way to prevent breast cancer from spreading to the brain. However, managing the disease early and effectively can reduce the risk. Advances in systemic therapies – particularly HER2-targeted drugs – are also helping to delay or prevent brain metastases in some patients.

Regular monitoring and open communication with healthcare professionals are key. For those at higher risk, prompt imaging when symptoms appear can lead to faster treatment and better outcomes.

With continued research progress, survival rates and quality of life for patients facing brain metastases are expected to improve significantly.

Centres of Excellence for Stereotactic Radiosurgery treatment of complex Brain Tumours