Brain metastases: a subtype-specific medical approach

Abstract

In the past, brain metastases were essentially all treated in the same way, and heralded a poor prognosis. Improvements in ways of delivering radiotherapy as well as in anaesthetic and neurosurgical techniques and in imaging mean that much more can be achieved. A knowledge of what subtype of breast cancer is being treated is now critical to take into account, especially in HER2 positive disease, where an expanding array of anti-HER2 drugs means that extra-cranial disease may be controlled for many years. Ideally, brain metastases should be managed in a multidisciplinary setting, so that imaging, radiation oncology and neurosurgery input can be combined.