Cerebral Metastases in Breast Cancer Patients: a Narrative Review

The purpose of this review is to address the rising incidence of cerebral metastases in breast cancer patients, which is now estimated to affect 30–40% of advanced breast cancer (ABC) patients.

Magnetic resonance imaging (MRI) remains the gold standard for brain metastases (BM) diagnosis, with follow-up scans recommended every 3 months. Treatment options for BM include neurosurgery, stereotactic radiosurgery (SRS), stereotactic fractionated radiation therapy (SFRT), or whole brain radiation therapy (WBRT), selected based on BM number, size, and location. Local therapies like SRS or neurosurgery are preferred for single or oligo metastases, while SRS or WBRT may be used for multiple BM. Concurrent systemic treatment tailored to tumor biology is crucial, particularly with recent advancements in HER2-positive patient management..

Symptomatic BM warrants local treatment alongside systemic therapy, considering patient condition and prognosis.