A 55-year-old woman with known breast cancer presents with a single 3 cm brain metastasis in the right frontal lobe with minimal edema. Her systemic disease is controlled and Karnofsky Performance Score is 80. What is the optimal management?

• A Whole brain radiotherapy alone
• B Stereotactic radiosurgery alone
• C Chemotherapy alone
• D Surgical resection followed by stereotactic radiosurgery to the cavity ✓

Explanation

For single accessible brain metastasis in patients with controlled systemic disease and good performance status, surgical resection followed by stereotactic radiosurgery (SRS) to the resection cavity is the standard of care. The Patchell trial demonstrated that surgery plus whole brain radiotherapy improved survival and functional independence compared to biopsy plus WBRT. Post-operative SRS to the cavity reduces local recurrence compared to surgery alone.

Reference: Bailey and Love's Short Practice of Surgery, 28th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.