With the advancement of treatment, the survival time of patients with advanced breast cancer is significantly longer, but the probability of central nervous system metastases in patients also increases. Although local treatments such as surgery and radiation therapy are still the main means of brain metastases, drug treatment of brain metastases has become the focus of research in recent years. In particular, anti-HER2 drugs, such as small-molecule tyrosine kinase inhibitors, have shown good efficacy in the drug treatment of HER2-positive brain metastatic breast cancer. In addition, some studies have also shown that drugs acting on other targets, such as anti-angiogenic drugs, PARP inhibitors, and immune checkpoint inhibitors, also have a certain effect on brain metastases.