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The decisions you may face, the aids that walk through them, the warnings on record, the first sixty days and the questions to ask.
One section per setting: the options named, what each is for, the trials behind them, the recorded trade-offs and the questions to ask.
Breast Cancer Now lists headache, sickness and vomiting especially on waking, weakness or numbness down one side of the body, unsteadiness or loss of balance, seizures, difficulty with speech, vision problems, and changes in behaviour, mood or memory among the signs that breast cancer may have spread to the brain. A seizure, a sudden severe headache or new one-sided weakness is 999 whatever the cause.
The NHS says to call 999 or go to A and E if you have cellulitis with a very high temperature or you feel hot, cold or shivery, a fast heartbeat or fast breathing, purple patches on the skin which may be less obvious on brown or black skin, feeling dizzy or faint, confusion or disorientation, cold, clammy or pale skin, or unresponsiveness. These are symptoms of serious complications, which can be life threatening.
Fainting, near-fainting, or an irregular or racing heartbeat; several kinase inhibitors prolong the QT interval and the labels require ECG and electrolyte monitoring.
Breathing very fast; confused, slurred speech or not making sense; blue, pale or blotchy skin, lips or tongue; a very high or very low temperature, feeling hot or cold to the touch, or shivery; a rash that does not fade when pressed: the NHS says call 999 or go to A and E, and do not drive yourself, ask someone to drive you or call 999.
NICE NG234 says to immediately contact the metastatic spinal cord compression coordinator if a person with a past or current diagnosis of cancer presents with bladder or bowel dysfunction, gait disturbance or difficulty walking, limb weakness, neurological signs of spinal cord or cauda equina compression, numbness, paraesthesia or sensory loss, or radicular pain, and to treat this as an oncological emergency. If you cannot reach anyone, go to A and E and say you have breast cancer and symptoms of spinal cord compression.
Bleeding that does not stop by itself, bleeding from more than one site, or new bruising in several places or one large area.
See all on the product pages:Bone metastases and skeletal-related eventsBrain metastases (intracranial disease)Compression, decongestive therapy and exercise for lymphoedemaFebrile neutropeniaLapatinibLymphadenectomy (lymph node dissection)Lymphoedema after breast cancer treatmentMetastatic spinal cord compression (MSCC)NeratinibNeutropenic sepsis: the temperature rule and the 999 signsPaclitaxel / nab-paclitaxelSeroma after breast surgerySurvivorship care and late-effects surveillanceTucatinib·Printable cards in the navigator
What the next twelve months look like, phase by phase, with the decision points.
Newly diagnosed? Read the first 60 days with HER2-positive breast cancer, then print the one-page appointment sheet with room for the answers.
Print this page for your appointment (your browser's print command). These prompts are for discussion; your clinical team knows your case.