Minimally invasive ablative techniques in the treatment of breast cancer: a systematic review and meta-analysis

Peek, MCL; Ahmed, M; Napoli, A; Usiskin, SI; Baker, RD; Douek, M

Abstract

Purpose: Breast conserving surgery is effective for breast cancer treatment but is associated
with morbidity in particular high re-excision rates. We performed a systematic review to
assess the current evidence for clinical outcomes with minimally invasive ablative techniques
in the non-surgical treatment of breast cancer.
Methods: A systematic search of the literature was performed using PubMed and Medline
library databases to identify all studies published between 1994 and May 2016. Studies were
considered eligible for inclusion if they evaluated the role of ablative techniques in the
treatment of breast cancer and included ten patients or more. Studies that failed to fulfil the
inclusion criteria were excluded.
Results: We identified 63 studies including 1608 patients whose breast tumours were treated
with radiofrequency (RFA), high intensity focused ultrasound (HIFU), cryo-, laser or
microwave ablation. Fifty studies reported on the number of patients with complete ablation
as found on histopathology and the highest rate of complete ablation was achieved with RFA
(87.1%, 491/564) and microwave ablation (83.2%, 89/107). Short-term complications were
most often reported with microwave ablation (14.6%, 21/144). Recurrence was reported in 24
patients (4.2%, 24/570) and most often with laser ablation (10.7%, 11/103). The shortest
treatment times were observed with RFA (15.6±5.6 minutes) and the longest with HIFU
(101.5±46.6 minutes).
Conclusion: Minimally invasive ablative techniques are able to successfully induce
coagulative necrosis in breast cancer with a low side effect profile. Adequately powered and
prospectively conducted cohort trials are required to confirm complete pathological ablation
in all patients.

Citation

Peek, M., Ahmed, M., Napoli, A., Usiskin, S., Baker, R., & Douek, M. (2016). Minimally invasive ablative techniques in the treatment of breast cancer: a systematic review and meta-analysis. International Journal of Hyperthermia, 33(2), 191-202. https://doi.org/10.1080/02656736.2016.1230232

• Journal Article Type: Article
• Acceptance Date: Aug 25, 2016
• Online Publication Date: Aug 30, 2016
• Publication Date: Oct 2, 2016
• Deposit Date: Jan 31, 2017
• Journal: International Journal of Hyperthermia
• Print ISSN: 0265-6736
• Electronic ISSN: 1464-5157
• Publisher: Taylor and Francis
• Volume: 33
• Issue: 2
• Pages: 191-202
• DOI: https://doi.org/10.1080/02656736.2016.1230232
• Publisher URL: http://dx.doi.org/10.1080/02656736.2016.1230232
• Additional Information: Funders : Theraclion Ltd