Onkologie. 2026:20(4):207-212 | DOI: 10.36290/xon.2026.036

Breast cancer with brain metastases: clinical and therapeutic aspects

Michaela Klimeš Lipánová, Eva Strecková, Tomáš Büchler

Onkologická klinika, 2. LF UK a Fakultní nemocnice Motol a Homolka, Praha

Brain metastases from breast cancer represent a serious complication of advanced disease and significantly affect patient morbidity and mortality. The highest risk of their development is associated with HER2-positive and triple-negative subtypes, while the incidence is lower in hormone receptor-positive tumors. The pathogenesis involves a complex metastatic cascade with a key role of the blood-brain barrier. Clinical presentation is variable and depends on the location and extent of involvement, with the most common symptoms including headache, neurological deficits, and cognitive impairment. Diagnosis is primarily based on contrast-enhanced magnetic resonance imaging of the brain. The treatment of brain metastases is often multimodal and includes surgery, radiotherapy, and systemic therapy. In recent years, significant progress has been made particularly in the field of targeted therapy for HER2-positive breast cancer, including tyrosine kinase inhibitors and antibody-drug conjugates. Despite these advances, the prognosis of patients remains poor, especially in the triple-negative subtype.

Keywords: breast cancer, brain metastases, blood-brain barrier, tyrosine kinase inhibitors, antibody-drug conjugates, local therapy.

Accepted: September 21, 2026; Published: October 9, 2026  Show citation