Brain metastases of breast cancer

Breast cancer is the first cancer of women in the world and in Tunisia with an incidence of 46.3 and 37.8 cases / 100 000 inhabitants per year respectively. It is the second cause of cancer mortality in women in Tunisia with 17 deaths / 100 000 inhabitants per year.The management of metastatic breast cancer has undergone several advances over the past decades leading to an improvement in patient survival. However, 15 to 30% of patients will develop brain metastases (BM) during their disease. They can occur synchronously (at the time of diagnosis of the primary cancer) or metachronously (after 6 months of the end of the primary cancer treatment). The management of CD is multidisciplinary, involving neurologists, neurosurgeons, radiologists, radiation oncologists, medical oncologists and pathologists.Radiation therapy (RT) is one of the pillars of CD treatment and has long been the standard treatment with its different modalities.The place of surgery is discussed according to the operability and resectability of metastases, as well as the status of systemic disease.Systemic treatment can be based on chemotherapy, hormonal therapy and targeted therapy and depends on the terrain, molecular classification and previously prescribed treatments.