Management of breast cancer brain metastases

Brain metastases are usual in breast cancer with poor prognosis and few available therapeutic options. The efficacy of epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) against brain metastases from EGFR mutation-positive non-small cell lung cancer (NSCLC) showed promising antitumor activity, on the other hand, the main treatment of breast cancer brain metastases (BCBMs) is only local therapy such as surgery or radiotherapy. The goal of treatment includes stabilizing or improving neurological function and palliating neurological symptom. In addition, the breast cancer subtype appears to be associated with the incident and the prognosis of brain metastases. And more, BCBMs have various faces such as brain parenchymal metastases, leptomeningeal carcinomatoses and intracranial dural metastases. Needless to say, for these metastases the early diagnosis and the appropriate therapeutic approach for an individual patient should be considered. This review described neurological management and therapeutic decisions of BCBM in consideration the subtype and showed representative MRI images.