Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.
JCO Oncol Pract. 2024 Oct;20(10):1348-1359. doi: 10.1200/OP.23.00794. Epub 2024 May 15.
The mechanisms underlying breast cancer brain metastasis (BCBM) development are complex, and its clinical presentation varies depending on the number, location, and size of brain metastases. Common symptoms include headache, neurologic deficits, and seizures. Diagnosis of BCBM typically relies on neuroimaging techniques, such as magnetic resonance imaging and computed tomography scans. Local therapies, such as surgery and stereotactic radiosurgery, can be used to control tumor growth and relieve symptoms. Whole-brain radiotherapy has been a mainstay of treatment for BCBM, but its use has been associated with cognitive decline. Systemic therapy with chemotherapy and targeted agents plays an increasingly important role in the management of BCBM. Novel agents, such as human epidermal growth factor receptor 2 (HER2)-targeted therapies and tyrosine kinase inhibitors, have shown promising results in improving survival for patients with HER2-positive and triple-negative BCBM. This comprehensive review synthesizes current knowledge, clinical insights, and evolving paradigms to provide a robust understanding and roadmap for optimizing the diagnosis and management of BCBM.
乳腺癌脑转移（BCBM）的发病机制复杂，其临床表现取决于脑转移的数量、位置和大小。常见症状包括头痛、神经功能缺损和癫痫发作。BCBM 的诊断通常依赖于神经影像学技术，如磁共振成像和计算机断层扫描。局部治疗，如手术和立体定向放射外科，可用于控制肿瘤生长和缓解症状。全脑放疗一直是 BCBM 的主要治疗方法，但它的使用与认知能力下降有关。化疗和靶向药物的全身治疗在 BCBM 的管理中发挥着越来越重要的作用。新型药物，如人表皮生长因子受体 2（HER2）靶向治疗和酪氨酸激酶抑制剂，已显示出在提高 HER2 阳性和三阴性 BCBM 患者的生存率方面的有前景的结果。本综述综合了当前的知识、临床见解和不断发展的范例，为优化 BCBM 的诊断和管理提供了全面的理解和路线图。
