Role of ablation in the treatment of breast cancer: A review

Breast cancer surgical treatment has evolved from the days of the radical mastectomy to breast conservation surgery. In recent years, there has been much interest in percutaneous treatment modalities for breast cancer, instead of surgery. There are several different methods of percutaneous treatment of breast cancer. These include cryoablation, radiofrequency ablation, microwave ablation, laser ablation, and ultrasound ablation. The advantages of these techniques include an outpatient or office procedure, with local anaesthesia; minimal scarring, which is only from introducing the percutaneous instrument into the breast, instead of a surgical incision; and minimal recovery time, as the procedure does not involve surgery or general anaesthesia. Disadvantages relate mainly to pathologic evaluation, in that the true size of the breast cancer has to be estimated from the pre-procedure imaging, and all molecular profiling must be obtained from the biopsy specimen. In addition, long term patient satisfaction with cosmesis after adjuvant radiotherapy has not been studied. We review these percutaneous ablation modalities in this paper, as well as their individual techniques, associated advantages, and disadvantages. We also review current clinical trials, exploring these methods of breast cancer treatment.