Study results suggest that some breast cancer patients should receive regular brain MRI (magnetic resonance imaging) scans even if they have no symptoms.
The Breast Cancer Research Team in the Division of Medical Oncology at Yonsei Cancer Hospital announced on the 18th that routine brain MRI screening in breast cancer patients can enable early detection of brain metastases.
Current domestic and international treatment guidelines recommend regular brain MRI screening only for patients with advanced breast cancer who have specific neurologic symptoms. However, patients with HER2 (human epidermal growth factor receptor 2)–positive disease, who account for 15–25% of all breast cancer cases, and those with triple-negative breast cancer, who account for 10–20%, have a higher risk of developing brain metastases than patients with other breast cancer subtypes. As a result, the need for earlier detection has been continuously discussed.
Accordingly, the research team performed routine brain MRI screening in 112 patients with advanced HER2-positive or triple-negative breast cancer who were treated at Yonsei Cancer Hospital from 2018 to 2023 and had no symptoms of brain metastases. A total of three scans were performed: at the time of breast cancer diagnosis and at points such as when second-line and third-line treatments were initiated.
As a result, the initial scan at the time of breast cancer diagnosis found that 9.8% of patients already had progressing, asymptomatic brain metastases, and by the third scan, brain metastases were detected in 19.6% of all patients. Notably, in 67% of patients who developed brain metastases, the metastases were detected before any neurologic symptoms appeared.
The research team explained that even when patients do not experience clearly noticeable symptoms, the best approach is to detect brain metastases early through routine screening. In other words, rather than reacting after symptoms develop, clinicians should proactively pursue early detection and establish a treatment strategy.
Professor Son Ju-hyuk of the Division of Medical Oncology at Yonsei Cancer Hospital emphasized the importance of early detection, stating, “With the recent emergence of anticancer drugs that are effective against brain metastases, a treatment environment is being established in which, if detected early, we can simultaneously expect prolonged survival and improved quality of life.”
These findings were published in the latest issue of the official journal of the European Society for Medical Oncology (ESMO). The research team plans to further demonstrate the need for brain MRI screening in asymptomatic breast cancer patients through a large-scale study.
