Radiofrequency ablation for breast cancer

Although breast-conserving therapy or mastectomy remains the gold standard for breast cancer treatment, minimally invasive alternatives to surgery are becoming more attractive for select patient populations. Advances in technology, reduced morbidity, improved cosmesis, and the ability to provide treatment in an outpatient setting are some of the advantages of image-guided therapy. Radiofrequency ablation (RFA) has been investigated because of its relatively low cost, low morbidity, and favorable technical success rates (76%-100% in published series). Image guidance during ablation involves the use of real-time ultrasound or magnetic resonance imaging to target the tumor and monitor the adequacy of ablation. Tumor size, location, histologic type, and reliable visualization under ultrasound (or other imaging modalities) are important to determine patient eligibility and procedural planning. In patients with localized breast cancer who decline surgery or are not candidates for surgery, RFA alone, or in combination with hormonal therapy, or followed by conventional radiation therapy with or without chemotherapy may prove to be viable treatment options. In patients with locally advanced or metastatic disease, RFA may be suitable for palliation of larger symptomatic tumors. Additional studies with long-term patient follow-up are necessary to better understand response to RFA and to determine its future role in the treatment algorithm for breast cancer.