“Pial metastasis of breast cancer is one of the serious complications of advanced breast cancer. Its clinical manifestations are complex and changeable, the course of disease progresses rapidly, and the prognosis of patients is very poor. With the progress of medical technology, the development of new diagnostic methods and comprehensive treatment models, the survival period of patients is continuously extended, and the incidence rate of leptomeningeal metastasis of breast cancer is also increasing year by year. At present, there is no unified standard for the diagnosis and treatment strategy of leptomeningeal metastasis of breast cancer at home and abroad, and there are differences between different regions and institutions. In order to standardize and improve the diagnosis and treatment of leptomeningeal metastasis of breast cancer in China, the consensus expert group systematically elaborated the epidemiology, high-risk factors, diagnosis strategies, treatment plans and follow-up evaluation points of leptomeningeal metastasis of breast cancer on the basis of comprehensive evaluation of existing evidence-based medical evidence, combined with clinical experience, and formed 13 recommendations, covering diagnosis (recommendations 1-4), systematic treatment (recommendations 5-7), local treatment (recommendations 8-10), and support for treatment and multidisciplinary team management (recommendations 11-13). This consensus aims to provide practical diagnosis and treatment reference for clinicians, promote the standardized management of leptomeningeal metastasis of breast cancer, and ultimately improve the prognosis of patients. This consensus has been registered on the Practice guideline Registration for Transparency (PREPARA) platform (registration number: PREPARA-2026CN273).”