Just interested in what other trusts do.
We had a regional meeting few months ago when Dr Aznar-Garcia gave a talk about SRS, he was very much against WBRT. He said that it wouldn’t be unreasonable for high risk patients to have a MRI every year from diagnosis of SBC so that SRS is more accessible to patients with fewer brain mets. At NUH will treat with SRS with a total of 8-9 mets.
Have done a literature review and got a few recent articles this morning, thought might be good to do a retrospective study to look at our case load to look at incidence of brain mets, treatments & life expectancy.
We do not normally screen or do baseline ct head.
If a suspicion of brain mets then tend to opt for MRI as if the go on for surgery or stereo tactic then neuro mdt will require MRI
Good to see you on here.
This is a question we are often asked here at BCC when we are talking to people with SBC. I'll be interested to see any further answers after Judiths post but I suspect many units won't scan routinely as current guidance does not recommend this (4th International Consensus Guidelines 2018)
Brain imaging should not be routinely carried out in asymptomatic patients. This approach is applicable to all patients
with ABC including those with HER2- positive and/or metastatic TNBC.
I've been told this is because there is no current evidence to say treating early improves survival (but that a diagnosis may of course affect quality of life psychologically and of course practically when they can't drive). I've no idea if there is any research that might result in a change of practice in the future.
We routinely scan all HER 2+ve & triple negative patients post diagnosis of SBC as a baseline. We do not then routinely continue to scan them unless they become symptomatic.
I started working as a SBC CNS in October, it has really struck me the amount of patients who are diagnosed with brain mets when other disease is stable or shortly after a SBC diagnosis. Patients are only scanned once develop symptoms. With improvements of targeted treatment such as SRS, does anybody screen patients regularly? If so what criteria do you use?