Minimally-invasive thermal ablation of early-stage breast cancer: a systemic review.

BACKGROUND Minimally-invasive thermal ablation techniques provide an effective approach for local destruction of solid tumor. A novel application is the use for treatment of early-stage breast carcinoma. METHODS A broad search was conducted in Pubmed, Embase and the Cochrane databases between January 1990 and December 2009. Clinical results of the relevant articles were collected and analyzed. RESULTS The analyzed studies were almost all feasibility or pilot studies using different energy sources, patients, tumor characteristics and ablation settings. They were conducted in research settings for the assessment of technical safety and feasibility, and none of those was used alone in clinical practice. Despite many methodological differences, complete tumor ablation could be achieved in 76-100% of breast cancer patients treated with radiofrequency ablation, 13-76% in laser ablation, 0-8% in microwave ablation, 36-83% in cryoablation, and 20-100% in high-intensity focused ultrasound ablation. CONCLUSION Minimally-invasive thermal ablation is a promising new tool for local destruction of small carcinomas of the breast. Large randomized control studies are required to assess the long-term advantages of minimally-invasive thermal ablation techniques compared to the current breast conserving therapies.