Improving Prognosis and Quality of Life for Breast Cancer: Linda’s Journey with ECCT Alongside Long-Term Cancer Treatment

Singapore, Linda was first diagnosed in 2008 with right breast cancer, ER/PR-negative and HER2-positive, stage T2N1M0. She underwent surgery with mastectomy and latissimus dorsi flap reconstruction, followed by five cycles of TCH chemotherapy and maintenance trastuzumab (Herceptin).

For a while, treatment was focused on controlling the original disease. But in 2011, the cancer recurred and had spread to the bones, lymph nodes and lungs.

From there, Linda entered what would become a long sequence of treatments. Over the years, she received different HER2-targeted therapies and chemotherapy combinations, including:

• Herceptin with Navelbine

• T-DM1, which provided approximately five years of progression-free survival

• Herceptin with Xeloda

• Herceptin with carboplatin

• Radiotherapy to the left pelvis

• Herceptin, Pertuzumab and Taxotere, followed by maintenance Herceptin and Pertuzumab after achieving a complete response

• Doxil

• Infusional Adriamycin

• Gemcitabine, carboplatin and Phesgo

• A HER2 bispecific antibody phase 1 clinical study

• Trastuzumab deruxtecan after progression involving the liver and bones

• Capecitabine, trastuzumab and tucatinib after further liver progression.

Then Came the Brain Metastases

The next major challenge was the brain. A PET-CT in March 2025 identified abnormal areas in the right parietal and left frontal regions of the brain that required further assessment. The scan also showed stable treated liver metastases, while some bone lesions demonstrated increased FDG activity.

A subsequent MRI confirmed two brain metastases, involving the left frontal and right parietal lobes. Linda underwent stereotactic radiosurgery (SRS), completed in April 2025. Linda continued to receive her established medical care, including HER2-targeted treatment and chemotherapy.

In January 2026, MRI of the brain showed stable intracranial lesions, with the left frontal lesion measuring approximately 1.2 cm and the right parietal lesion showing features that favoured radiation necrosis. There were no new enhancing brain lesions.

At this point, the situation was clearly complicated. Linda was not dealing with a single isolated tumour. Her history included metastatic disease involving the bones, lymph nodes, lungs, liver and brain, with years of previous systemic treatment behind her.

Linda began ECCT in May 2026 while continuing her oncology treatment. Importantly, ECCT was not introduced as a replacement for her oncology treatment to Improving Prognosis and Quality of Life for Breast Cancer. Linda continued to receive her established medical care.

In June 2026, there was an encouraging change. The MRI brain showed that the left frontal lesion had decreased in size to approximately 1.2 cm. The right parietal lesion remained stable, and no new enhancing brain masses were seen.

At the same time, CT imaging of the chest, abdomen and pelvis showed a reduction in a hepatic segment 4a lesion, decreasing from 1.2 cm in March 2026 to 0.9 cm in June 2026. Other previously treated liver lesions remained stable. There was no evidence of local recurrence, while the known bone metastases and pathological fractures were also stable.

During her later review, Linda also shared that her oncologist had commented that improvement was visible on the CT scan performed approximately one month after she started ECCT.

Then came an unexpected complication. In July 2026, Linda experienced focal seizures. She remained conscious during the episodes, but brain imaging showed an acute intratumoral haemorrhage within the known left frontal metastasis. The haemorrhagic focus measured approximately 2.0 cm on the initial CT scan.

A repeat CT two days later showed the haemorrhagic focus to be grossly stable at approximately 1.8 cm, with no new acute intracranial haemorrhage.

The subsequent MRI on 31 July showed the left frontal lesion measuring up to 1.7 cm with intralesional haemorrhage and mildly increased surrounding oedema. The right parietal lesion remained grossly stable, although with increased surrounding oedema. Once again, there were no new enhancing intracranial lesions.

She was treated with dexamethasone and levetiracetam and discharged with follow-up plans for continued oncology treatment and repeat MRI surveillance. So this was certainly not a story where everything suddenly became easy after starting ECCT. Linda's disease remained medically complex, and the July seizure and intratumoral haemorrhage were serious events requiring hospital assessment and medical management.

Feeling Better in Everyday Life

By the August 2026 review, Linda described feeling good after starting ECCT.

She reported improved sleep and better energy levels. She was able to exercise and go for brisk walks. Perhaps one of the changes she noticed most clearly was her recovery after chemotherapy.

She explained that after chemotherapy, she was still able to go for walks and felt that her recovery was different after she had started ECCT sessions.

For someone who has been through repeated lines of chemotherapy over many years, that difference in day-to-day recovery matters.

It is easy to focus only on tumour measurements and forget the human side of treatment. But being able to sleep better, feel more energetic, walk after chemotherapy and continue working are meaningful parts of quality of life.

During ECCT sessions, Linda described feeling warmth and occasional electrical sensations. She remained engaged in her own care and continued to balance treatment with ordinary life.

But what is striking is what happened around all of this. Even after this difficult episode, Linda was still working. And despite the complexity of her medical history, she continued to describe positive changes in sleep, energy and physical activity after starting ECCT. She was able to brisk walk and felt that her recovery after chemotherapy had improved.

That, perhaps, is the part of Linda's journey that is easiest to overlook when reading a stack of radiology reports. A patient can have stable lesions, shrinking lesions, treated metastases, radiation necrosis, viable tumour, oedema and even an acute intratumoral haemorrhage, all in the same chapter of their medical history. But behind those medical terms is a woman who is still getting up, still working, still walking and still trying to live as normally as possible.

Linda's case reflects a long and complex journey with recurrent HER2-positive metastatic breast cancer. Over nearly two decades, she has undergone surgery, reconstruction, multiple lines of chemotherapy, HER2-targeted therapy, antibody-drug conjugates, radiotherapy, stereotactic radiosurgery and participation in a clinical trial. ECCT was later added alongside her ongoing oncology treatment rather than replacing it.

Following the introduction of ECCT, the documented follow-up included subjective improvements in sleep, energy, exercise tolerance and recovery after chemotherapy. Imaging during this period showed a decrease in the left frontal lesion between March and June 2026, stability of the right parietal lesion, no new brain metastases, and a reduction in one hepatic lesion from 1.2 cm to 0.9 cm, while other treated liver and bone lesions remained stable.

Beyond every scan, measurement and medical term, quality of life is also about being able to wake up, get dressed, go to work, take a brisk walk and still feel that life, somehow, continues.

Disclaimer: This case describes one individual's documented medical journey and is provided for educational and informational purposes only. ECCT was used alongside ongoing oncology care, and the changes described cannot be attributed to ECCT alone. It does not constitute medical advice and should not be used as a substitute for professional medical consultation, diagnosis or standard-of-care treatment. Individual outcomes may vary, and this case should not be interpreted as a guarantee or indication that any particular outcome, response, improvement or result will occur in another individual.