Radiological response of brain metastases to novel tyrosine kinase inhibitor lapatinib.

A 54-year-old woman with stage IV right breast cancer presented to our oncology clinic with 2week history of headache, nausea and gait instability. Six months ago, she was diagnosed with T4N1M1 lobular carcinoma of right breast, which was estrogen receptor and progesterone receptor negative but over expressed human epidermal growth factor receptor (HER-2 3+). She received neoadjuvant chemotherapy with doxorubicin and cyclophosphamide with an excellent response, and then started on docetaxel, pertuzumab and trastuzumab. She underwent right total mastectomy with axillary node dissection. Two weeks after surgery, she presented with the above-mentioned neurological symptoms. Magnetic resonance imaging (MRI) scan of brain revealed numerous nodular