Breast cancer metastasis to the central nervous system

As breast cancer patients live longer, the development of central nervous system (CNS) metastases has become more prevalent. Clinically symptomatic breast cancer metastasis to the CNS is associated with significant morbidity and mortality. The blood-brain barrier (BBB) and the unique microenvironment and pathophysiology of the CNS create treatment challenges in this unique population. New therapeutic approaches are advancing the limits of the management of metastatic breast cancer to the CNS. Enhancements in surgical techniques and in targeted radiation are allowing better control of CNS metastases, while chemotherapy and targeted agents continue to play a major role in the treatment and research efforts. In addition to brain metastases, leptomeningeal carcinomatosis, spinal metastases and ocular metastases present particular challenges to clinicians and researchers. Future research efforts aimed at breast cancer patients with CNS metastases may focus on identifying patients at greater risk, enhancing treatment options, and identifying new diagnostic and predictive markers.