Minimally invasive surgery for small breast cancer

J Surg Oncol. 2003 Oct;84(2):94-101; discussion 102. doi: 10.1002/jso.10292.

Abstract

Background and methods: So-called minimally invasive techniques make percutaneous eradication of breast tumors possible, thus leading to breast-conserving treatment (BCT) without surgery. This paper reviews and discusses the feasibility of minimally invasive techniques for breast cancer.

Results: Although a wide variety of ablation techniques have been investigated for the treatment of primary breast cancer, radiofrequency ablation (RFA) remains one of the most promising and potentially useful tools. RFA therapy results in effective cell killing in a predictable volume of tissue with a low complication rate. On the other hand, ultrasonography is useful for guiding the needle within the tumor but cannot predict the extent of thermal ablation accurately. Early post-procedural magnetic resonance imaging (MRI) may be useful for assessing whether complete tumor ablation has been achieved by RFA. Whether adequate ablation of the tumor has been achieved can be confirmed by extensive core needle sampling of the treated area. However, validation of the margin status is also important and this needs to be tackled in further studies.

Conclusions: There are many problems that remain before RFA therapy can be considered for conventional treatment. Further studies are needed to determine whether the use of RFA alone for local treatment of primary breast cancer will result in local recurrence and survival rates equivalent to those seen with BCT.

Publication types

  • Review

MeSH terms

  • Breast Neoplasms / diagnostic imaging
  • Breast Neoplasms / pathology
  • Breast Neoplasms / surgery*
  • Breast Neoplasms / therapy
  • Catheter Ablation / methods*
  • Combined Modality Therapy
  • Cryotherapy
  • Female
  • Humans
  • Laser Coagulation
  • Magnetic Resonance Imaging
  • Mastectomy, Segmental*
  • Minimally Invasive Surgical Procedures*
  • Prognosis
  • Ultrasonography