Brain metastasis in breast cancer

Breast cancer (BC) is the most frequently diagnosed cancer among women worldwide It has also the second highest incidence of brain metastasis among all malignancies, with the reported prevalence ranging from 15% to 50%. Patients with HER2-positive and triple-negative breast cancer have a higher risk of developing BMs than patients with luminal tumors. Despite theevolving strategies in the diagnosis and treatment of breast cancer, patients who develop brain metastasis tend to have poorer prognosis. Fortunately, novel treatment modalities are emerging in this regard, including local and systemic therapies; these additional treatment options aim to improve symptoms, stabilize or reduce the tumor burden, prevent central nervous system relapse, maintain quality of life, and improve overall survival. Many questions remain unanswered, like as the mechanisms blocking passage of therapeutic agents across the Blood Brain Barrier, as well as the immunologic proclivities of the brain microenvironment, which “if understood” will lead to better patients outcomes