New Research Supports Routine Brain MRI Screening in Asymptomatic Late-Stage Breast Cancer Patients

By MedImaging International staff writers
Posted on 14 Feb 2025

Image: The new findings warrant brain MRI surveillance recommendations for neurologically asymptomatic stage IV breast cancer (Photo courtesy of 123RF)

Currently, screening for asymptomatic brain metastasis in stage IV breast cancer patients using brain MRIs is not recommended. The prevalence of asymptomatic brain metastasis is not well established. However, a new study has revealed that asymptomatic brain metastasis is more common in stage IV breast cancer patients than previously thought. Published in Neuro-Oncology, the study suggests that doctors may need to reassess the existing screening guidelines for detecting brain metastasis in patients who do not show symptoms.

The research, conducted by scientists at Moffitt Cancer Center (Tampa, FL, USA), focused on 101 asymptomatic patients diagnosed with stage IV breast cancer, including those with triple-negative, HER2-positive, and hormone receptor-positive/HER2-negative breast cancer. These patients underwent MRI scans to check for brain metastasis, with a follow-up MRI six months later if the initial scan showed no signs of cancer spread. Among the patients who completed the initial MRI, 14% were found to have brain metastasis.

The rates of metastasis varied by subtype: 18% in triple-negative breast cancer, 15% in HER2-positive breast cancer, and 10% in hormone receptor-positive/HER2-negative breast cancer. After the second MRI, the percentage of patients with brain metastasis increased to about 25% across all subtypes. Following the diagnosis of brain metastasis, patients received early treatment, which included adjustments to systemic therapy and the addition of local therapies.

“Our study suggests that asymptomatic brain metastasis is quite common in stage 4 breast cancer,” said Kamran Ahmed, M.D., associate member and section chief for Breast Radiation Oncology at Moffitt and principal investigator of the study. “Although larger studies are needed to confirm our findings, given the improvements in systemic and local therapies for breast cancer brain metastasis, the time may be appropriate to reconsider current guidelines that recommend against routine MRI surveillance in late stage breast cancer.