Interdisziplinäre Therapie von Hirnmetastasen

In patients with metastatic breast cancer, the incidence of cerebral metastases has increased with advances in systemic therapy. With a diagnosis of central nervous system (CNS) metastasis, local therapy is indicated in most cases. Surgical treatment is possible for symptomatic metastases, singular metastases, or to obtain histology. Radiation of CNS metastases should be stereotactic, if possible. In the case of multiple brain metastases or relapses, whole-brain irradiation can be performed, which may be associated with cognitive impairment. In individual cases, local treatment may be postponed in the case of asymptomatic metastases and change of systemic therapy, particularly if stereotactic irradiation is not possible. Initial study data for patients with brain metastases are available, but there is a great need for clinical and translational research.