Since most patients with brain metastases from breast cancer have disseminated disease elsewhere and a dismal prognosis when treated by whole brain irradiation alone, we investigated the use of systemic chemotherapy in 66 such patients. Fifty-two percent (34 of 66 patients) demonstrated an objective response to this therapy which was similar to the results obtained in patients treated for extracranial metastases. Eighteen patients who subsequently had recurrence of brain metastases were successfully retreated with secondary chemotherapy. The median duration of remission in 34 responders was ten months. The median survival, from the time of chemotherapy for brain metastases, was 13.1 months in 34 responders (range 5–74+) vs. 3.0 months in 32 non-responders (P <>