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Minimally Invasive Ablative Therapies for Invasive Breast Carcinomas: An Overview of Current Literature

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Abstract

Background

Minimally invasive treatment may be an alternative to breast-conserving surgery.

Methods

A structured PubMed, Embase, Cochrane, and Web of Science search was performed. Endpoints studied were feasibility, completeness of ablation, timing of the sentinel node biopsy (SNB), imaging modalities, and treatment-related complications.

Results

A total of 24 articles were retrieved, and the level of evidence varied (2B-4). Mainly phase II studies with a treat-and-resect protocol were analyzed. Up to 100% completeness of ablation was reported for radiofrequency ablation (RFA), cryosurgery, and focused ultrasound (FUS). The oncologic results need further evaluation. Dynamic contrast enhanced MRI seems to be the best method for monitoring treatment response (77% sensitivity, 100% specificity). Ultrasound is suitable for guiding probes into the tumor. There is no consensus on the timing of the SNB.

Conclusions

All studies on minimally invasive ablative modalities published so far show that these techniques are feasible and safe. At this stage only T1 tumors should be ablated in a clinical trial setting; it is unclear which of the modalities is most suitable.

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Authors and Affiliations

  1. Department of Surgery, University Medical Center Utrecht, P.O. Box 85500, 3508, GA, Utrecht, The Netherlands

    Stijn van Esser, Inne H. M. Borel Rinkes & Richard van Hillegersberg

  2. Department of Radiology, University Medical Center Utrecht, P.O. Box 85500, 3508, GA, Utrecht, The Netherlands

    Maurice A. A. J. van den Bosch & Willem Th. M. Mali

  3. Department of Pathology, University Medical Center Utrecht, P.O. Box 85500, 3508, GA, Utrecht, The Netherlands

    Paul J. van Diest

  4. Department of Surgical Oncology, University Medical Center Utrecht, E 01805, Heidelberglaan 100, 3584, CX, Utrecht, The Netherlands

    Stijn van Esser

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  1. Stijn van Esser
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  2. Maurice A. A. J. van den Bosch
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Correspondence to Stijn van Esser.

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van Esser, S., van den Bosch, M.A.A.J., van Diest, P.J. et al. Minimally Invasive Ablative Therapies for Invasive Breast Carcinomas: An Overview of Current Literature. World J Surg 31, 2284–2292 (2007). https://doi.org/10.1007/s00268-007-9278-x

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