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Bone metastatic
Hello Doctor,
I’m seeking a second opinion regarding my mother’s latest whole-spine MRI done on 1st December 2025. Her cancer reoccurred in the bones with metastasis (Stage 4) in 2022, after which she underwent chemotherapy and radiotherapy, and has been on monthly immunotherapy (Trastuzumab) since then till today.
MRI Findings (1st Dec 2025)
Interval progression of vertebral metastatic lesions
New metastatic lesions at D6 and L1
Clumping of cauda equina roots at L1–L2
Worsening D7 vertebral compression
Nerve root narrowing at L4–L5 and L5–S1
Clinical symptoms:
Numbness below the knee
Persistent pain despite ongoing treatment
Could you please review the report and advise if this requires urgent intervention, additional tests, or any change in her treatment plan?
Thank you, Doctor.
Answers (3)
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Her 2 positive on trastuzumab
Progressive spinal metastasis
Plan -
medical oncology opinion for pertuzumab+ zolendronic acid or denosumab
Radiation oncology opinion - Palliative RT D6 To L2 vertebrae
Decompression and stabilisation of D7
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She needs
1. a PETCT to see if the disease has progressed elsewhere
2. Ortho/ Spine surgery opinion on need for surgical intervention
3. Radiation therapy for the new lesions
4. Symptomatic treatment- analgesics/steroids
5. Dorsolumbar brace
6. May discuss change in ongoing targeted therapy if systemic progression.
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Do a pet if not done in 3 months
Consult radiation oncologist with pet ct for ablation of pressure causing lesions.. radiation therapy is highly effective esp sbrt
Next Steps
Pet and meet radiation oncologist
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Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.