brainmetsbc.org

Symptoms and Diagnosis

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Symptoms of Brain Metastases *

The symptoms of brain metastases can vary, depending upon the location, since different parts of the brain govern different functions.  But there are some common symptoms that have more to do with the swelling that is typical with brain mets, and the pressure this causes on the brain. 

  • ¬†Headache
  • ¬†Changes in cognition and mental status (ability to think, understand and use words correctly)
  • ¬†Emotional changes
  • ¬†Weakness
  • ¬†Dizziness
  • ¬†Visual changes (seeing lights, seeing double, or narrowing of vision)
  • ¬†Problems with balance
  • ¬†Seizures
  • ¬†Nausea and vomiting
  • ¬†Sensory changes (changes in smelling, taste, hearing)

* Many of these symptoms can have other causes, including side effects from chemotherapy.  In general, symptoms that persist are more suspicious, like a headache that is worse in the morning, lasts for days, or recurs every day,

Diagnosis

MRI (magnetic resonance imaging) with gadolinium (image enhancer that provides better contrast) is the most effective technology for diagnosing breast cancer brain metastases. MRI with contrast does a better job than CT (computed tomography) scanning with contrast. MRI also does a better job in distinguishing a single metastasis from multiple metastases, which is an important factor in determining what kind of treatment a patient needs.

At this time, the accuracy of a PET scan for diagnosis of brain metastases is unknown and is therefore not recommended. If the diagnosis is uncertain, a brain biopsy may be done. This is an invasive procedure in which the surgeon physically removes a portion of the tissue in question from the brain in order to determine if it is a metastasis. This may be necessary because sometimes what looks like a brain metastasis on an MRI could be a primary brain tumor, a meningioma (a growth that isn't cancer), another cedntral nervous system (CNS) disease, a previous stroke, or radiation necrosis from the treatment of a previous metastasis.  Sometimes, it is helpful for the surgeon to remove all of the tissue of a lesion, especially if it appears to be the only one in the brain.