Strengths and weakness of the evidence

Limited high quality evidence was available for the five primary research questions.

There were few large prospective trials identified that investigated the use of surgery, radiotherapy, systemic therapies or multimodal treatment for the management of CNS metastases in women with metastatic breast cancer, specifically from breast cancer. Most of the relevant trial data were limited to small breast cancer patient cohorts or retrospective studies.

The following studies were identified for women with CNS metastases from metastatic breast cancer:

  • one randomised controlled trial
  • one randomised phase II study
  • one cohort study
  • one non-comparative prospective study
  • 18 single arm prospective phase I and II studies
  • 26 retrospective studies.

Seven previously published systematic reviews, including two Cochrane reviews, were also used as primary references. These systematic reviews included evidence from studies with mixed primary tumours