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Brain metastases from breast cancer

Case contributed by Angel Donato
Diagnosis certain

Presentation

History of infiltrating ductal carcinoma of the breast on chemotherapy. Currently presents with a headache.

Patient Data

Age: 35 years
Gender: Female

Innumerable scattered bilateral focal enhancing lesions in both cerebral and cerebellar hemispheres, with vasogenic edema and mass effect.

Conclusion

Large burden of intracranial metastatic disease.

Case Discussion

Breast cancer is the most common cause of brain metastases in females. It may metastasize to the brain via a hematogenous and leptomeningeal route.  This indicates a poor prognosis and a decreased quality of life. Approximately 10% to 16% of patients with metastatic breast cancer develop brain metastasis during their disease.

Risk factors implicated in the development of brain metastasis in patients with breast cancer include young age, negative hormone receptor status, human epidermal growth factor receptor 2 (HER2) amplification, and p53 overexpression.

Differential diagnosis of cerebral metastasis includes; brain abscesses, demyelinating disease, glioblastoma, and lymphoma.

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