TY - JOUR
T1 - Minimally invasive ablative therapies for invasive breast carcinomas
T2 - An overview of current literature
AU - Van Esser, Stijn
AU - Van Den Bosch, Maurice A A J
AU - Van Diest, Paul J.
AU - Mali, Willem Th M
AU - Borel Rinkes, Inne H M
AU - Van Hillegersberg, Richard
PY - 2007/12
Y1 - 2007/12
N2 - Background: Minimally invasive treatment may be an alternative to breast-conserving surgery. Methods: A structured PubMed, Embase, Cochrane, and Web of Science search was performed. Endpoints studied were feasibility, completeness of ablation, timing of the sentinel node biopsy (SNB), imaging modalities, and treatment-related complications. Results: A total of 24 articles were retrieved, and the level of evidence varied (2B-4). Mainly phase II studies with a treat-and-resect protocol were analyzed. Up to 100% completeness of ablation was reported for radiofrequency ablation (RFA), cryosurgery, and focused ultrasound (FUS). The oncologic results need further evaluation. Dynamic contrast enhanced MRI seems to be the best method for monitoring treatment response (77% sensitivity, 100% specificity). Ultrasound is suitable for guiding probes into the tumor. There is no consensus on the timing of the SNB. Conclusions: All studies on minimally invasive ablative modalities published so far show that these techniques are feasible and safe. At this stage only T1 tumors should be ablated in a clinical trial setting; it is unclear which of the modalities is most suitable.
AB - Background: Minimally invasive treatment may be an alternative to breast-conserving surgery. Methods: A structured PubMed, Embase, Cochrane, and Web of Science search was performed. Endpoints studied were feasibility, completeness of ablation, timing of the sentinel node biopsy (SNB), imaging modalities, and treatment-related complications. Results: A total of 24 articles were retrieved, and the level of evidence varied (2B-4). Mainly phase II studies with a treat-and-resect protocol were analyzed. Up to 100% completeness of ablation was reported for radiofrequency ablation (RFA), cryosurgery, and focused ultrasound (FUS). The oncologic results need further evaluation. Dynamic contrast enhanced MRI seems to be the best method for monitoring treatment response (77% sensitivity, 100% specificity). Ultrasound is suitable for guiding probes into the tumor. There is no consensus on the timing of the SNB. Conclusions: All studies on minimally invasive ablative modalities published so far show that these techniques are feasible and safe. At this stage only T1 tumors should be ablated in a clinical trial setting; it is unclear which of the modalities is most suitable.
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U2 - 10.1007/s00268-007-9278-x
DO - 10.1007/s00268-007-9278-x
M3 - Article
C2 - 17957404
AN - SCOPUS:36849051340
VL - 31
SP - 2284
EP - 2292
JO - World Journal of Surgery
JF - World Journal of Surgery
SN - 0364-2313
IS - 12
ER -