Brain metastases from primary breast cancer tumors often acquire clinically actionable genetic alterations, according to a small study. About one fifth of ERBB2/HER2-negative cases switched to HER2-positivity in the brain metastases.
A 22-year-old college student with primary amenorrhea due to Müllerian agenesis presented with a headache, dysarthria, nausea, vomiting, and left upper extremity weakness. MRI of the brain showed numerous intracranial lesions.
Epigenetic lesions, and not just genetic mutations, can cause brain cancer, and one important implication of that observation is that precision-medicine genetic and genomic tools will miss epigenetic lesions that may drive tumor growth or drug resistance.