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Thermal ablation therapies in patients with breast cancer liver metastases: A review

  • Vascular-Interventional
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Abstract

Background

The liver is involved in about half of patients with metastatic breast cancer. Unfortunately systemic chemotherapy as the treatment of choice is limited. Due to multifocality and/or insufficient remnant liver volume, the majority of liver metastases are also unresectable. Currently, thermal ablations are used in these patients with acceptable impact.

Methods

We reviewed studies on radiofrequency ablation (RFA), laser-induced thermotherapy (LITT) and microwave ablation (MWA) regarding local tumour response, progression and survival indexes in patients with breast cancer liver metastases (BCLM).

Results

The reviewed literature showed positive response rates of 63 % to 97 % in RF-ablated lesions, 98.2 % in LITT-treated lesions and 34.5–62.5 % in MW-ablated lesions. Median survival was 10.9–60 months using RFA, 51–54 months after LITT and 41.8 months using MWA. Five-year survival rates were 27–30 %, 35 % and 29 %, respectively. Local tumour progression ranged from 13.5 % to 58 % using RFA, 2.9 % with LITT and 9.6 % with MWA.

Conclusion

The reviewed literature demonstrated that ablation therapies either as single therapy or combined with other locoregional therapies are a good alternative as an adjunction to resection in patients with resectable lesions or with positive response using chemotherapy. However, multicentre randomised studies should be conducted to obtain further evidence of the benefits of these treatments in patients with BCLM.

Key points

Thermal ablation is an alternative treatment for hepatic metastases from breast cancer

This review assesses thermal ablation therapies and local chemoembolisation techniques

It helps prioritise treatment options for managing hepatic metastases from breast cancer

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Correspondence to Thomas J. Vogl.

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Vogl, T.J., Farshid, P., Naguib, N.N.N. et al. Thermal ablation therapies in patients with breast cancer liver metastases: A review. Eur Radiol 23, 797–804 (2013). https://doi.org/10.1007/s00330-012-2662-4

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  • DOI: https://doi.org/10.1007/s00330-012-2662-4

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