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Research Letter
July 2018

Implications of Screening for Brain Metastases in Patients With Breast Cancer and Non–Small Cell Lung Cancer

Author Affiliations
  • 1Department of Radiation Oncology, Dana-Farber/Brigham and Women’s Cancer Center, Harvard Medical School, Boston, Massachusetts
  • 2Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
  • 3Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, Massachusetts
  • 4Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota
  • 5Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
JAMA Oncol. 2018;4(7):1001-1003. doi:10.1001/jamaoncol.2018.0813

Brain metastases affect many patients with cancer.1 Given the limited intracranial penetration of most systemic therapies, the size and number of brain metastases at diagnosis determines management, with more invasive or toxic therapies such as neurosurgical resection and whole brain radiation therapy (WBRT) used for bulky and multifocal disease, respectively. Consequently, consensus guidelines from the National Comprehensive Cancer Network recommend screening magnetic resonance imaging (MRI) of the brain for patients with stage II to IV non–small cell lung cancer (NSCLC), small cell lung cancer of any stage, and stage IIIC to IV melanoma—all cancers that frequently metastasize to the brain.2