Introduction: While five-year survival in metastatic breast cancer improved during the last decades, the likelihood of metastases of the central nervous system (CNS) has risen equally, making breast cancer the second most common source of CNS metastases. Purpose of investigation: Though prognosis of CNS metastases is generally poor, the clinical courses differ depending on the patterns of the CNS and periphery metastases. Various treatment options for CNS metastases are established in daily practice. Materials and Methods: Current literature and guidelines were reviewed in order to determine the optimal treatment strategy for each meta-static situation. Conclusion: In case of singular CNS metastases, neurosurgical interventions are promising approaches, while multiple CNS metastases are usually treated by radiation therapy, which might be combined with systemic treatment. Localized chemotherapy is applied in cases of leptomeningeal spread and may be combined with systemic treatment if needed.