Breast Cancer Therapies and Nursing Care

Biography

Biography: Navneet Kaur

Abstract

Isolated midbrain metastasis from breast cancer is a rare occurrence. we present a classical clinic image of a women who presented with breast cancer with synchronous isolated midbrain metastasis. The brain is one of the common sites of metastases from breast cancer next only to the bone, liver and lung. Solitary brain metastases are now common with the increasing use of surveillance imagining. But isolated midbrain metastases is still a rare occurrence. A 50 year old perimenopausal lady presented to the neurologist with dropping of the right eyelid and diplopia. She was evaluated neurologically and found to have isolated third cranial or the Occulomotor nerve palsy on the right. A CECT i.e. Contrast enhanced Computerised Tomography was done on the brain reported a single space occupying lesion in the midbrain. When probed further, she revealed a right-sided breast lump. She was then referred to the surgical oncology department. Clinical evaluation did reveal a right-sided LABC i.e. locally advanced breast cancer with classical Peau’d orange appearance on her right breast . A trucut biopsy was done which confirmed invasive ductal carcinoma of breast. Even though the patient was very sick and lost to follow-up, the clinical picture is a classic spotter diagnosis. There are enough literature and guidelines to optimize the treatment of brain metastasis in breast cancer. But due to the proximity of numbers, isolated midbrain metastasis from breast cancer has not been addressed so well. However, in the era of precision radiation and targeted therapy, isolated mid brain metastasis is still potentially curable provided they present early. A multimodal approach including SBRT i.e.Stereotactic Body Radiation Therapy to the metastatic lesion in the midbrain along with systematic therapy will be the best practice in such a case.