Radiofrequency ablation as a treatment strategy for liver metastases from breast cancer

The American Cancer Society estimates that in 2007, 178,000 women in the United States will be diagnosed, and that 40,000 women will die from breast cancer. Metastatic breast cancer is a systemic disease, uncommonly involving an isolated organ. Liver metastases from breast cancer occur in ~50% of the patients who develop breast cancer metastases and are associated with a poor outcome. Hepatic metastasectomy as an adjuvant treatment even in patients with stable extrahepatic disease has been shown to impart a significant survival advantage over chemotherapy alone. In the treatment of hepatocellular carcinoma (HCC) and colorectal liver metastases (CRLM), radiofrequency ablation (RFA) has been shown to be a safe, minimally invasive treatment option with low morbidity and short hospital stay that is more readily repeatable than resection. The data supporting RFA of breast cancer liver metastases (BCLM) is currently limited to small, retrospective series that, like hepatic resection, have demonstrated adjuvant RFA improves survival compared with chemotherapy alone. This review will examine the rationale, indications, supportive data, and complications of RFA in the treatment of BCLM.