Brain metastases causing symptoms require immediate treatment. Your doctor will prescribe steroids first, followed by other treatments, such as surgery, chemotherapy, and/or radiation.
Surgery for brain metastases
Your doctor may use surgery to remove one small spot of cancer that shows up a long time after you were first diagnosed with breast cancer if the cancer is in an area that's safe to operate on. You may also need surgery if a single metastasis causing severe pressure in the brain does not respond to other treatments. But if several areas of cancer are in the brain or in other parts of the body, surgery is not usually a good option. Occasionally, if cancer is blocking the fluid drainage system in and around the brain, a tube might be placed to bypass the blockage. This tube is called a shunt.
Chemotherapy for brain metastases
When cancer cells get into the fluid that normally surrounds the brain and spinal cord, cancer may grow on individual nerves. This can cause you to lose feeling or movement in certain parts of your body. Symptoms may improve with steroids. But your doctor may also want to inject chemotherapy drugs directly into the fluid bathing the nerves. This is called intrathecal chemotherapy. This type of chemotherapy may reduce the number of cancer cells in the spinal fluid so they are less likely to cause new problems. But it's unlikely for this treatment to reverse problems already caused by the cancer.
Radiation therapy for brain metastases
Radiation can be aimed at the whole brain or specific nerves. It is rarely aimed at the entire spinal cord. Radiation to too large an area would lower the number of important infection-fighting cells, which can delay the start and continuation of chemotherapy.