In addition, brain metastases are a major cause of morbidity, associated with progressive neurologic deficits that result in a reduced quality of life .
With the advent of better systemic therapies, brain metastases constitute an increasing clinical problem.
Finally, the burden of disease represented by the number of brain metastases, as well as the presence of uncontrolled extracranial disease have both been related with worse prognosis [23, 24, 26].
One of the most frequently used tools for the assessment of prognosis in brain metastases is the graded prognostic assessment (GPA) .
The prognosis of patients with breast cancer who develop brain metastases is affected by several factors.
Tumor subtypes have been identified as a prognostic factor for overall survival in brain metastases [20, 21].
This is particularly important in HER2-positive patients, in whom brain metastases can occur in the setting of controlled extracranial disease .
This review will focus on the key issues of current treatment options, comment on novel therapies and ongoing clinical trials for patients with breast cancer brain metastases.This prognostic index includes age, KPS score, number of brain metastases and extracranial metastases.After its original validation , the index was modified to create a breast cancer-specific GPA that included tumor subtypes among its prognostic factors [11, 14].In addition to the KPS, patient’s age can also affect prognosis.Older age at the time of initial breast cancer diagnosis has been associated with shorter overall survival and shorter survival from the time of first tumor relapse [5, 25].