The Evolving Role of Ultrasound Guided Percutaneous Laser Ablation in Elderly Unresectable Breast Cancer Patients: A Feasibility Pilot Study

Abstract

Background and Objectives Breast-conserving surgery represents the standard of care for the treatment of small breast cancers. However, there is a population of patients who cannot undergo the standard surgical procedures due to several reasons such as age, performance status, or comorbidity. Our aim was to investigate the feasibility and safety of percutaneous US-guided laser ablation for unresectable unifocal breast cancer (BC). Methods Between December 2012 and March 2017, 12 consecutive patients underwent percutaneous US-guided laser ablation as radical treatment of primary inoperable unifocal BC. Results At median follow-up of 28.5 months (range 6-51), no residual disease or progression occurred; the overall success rate for complete tumor ablation was therefore 100%. No significant operative side effects were observed, with only 2 (13.3%) experiencing slight to mild pain during the procedure, and all patients complained of a mild dull aching pain in the first week after procedure. Conclusions Laser ablation promises to be a safe and feasible approach in those patients who are not eligible to the standard surgical approach. However, longer follow-up results and larger studies are strongly needed.

The Efficacy and The Safety of Ultrasound-guided Ablation Therapy for Treating Papillary Thyroid Microcarcinoma

“…The laser technology had broad clinical application in many diseases, such as unresectable breast cancer 18, renal tumor 19, hepatocellular carcinoma (HCC) 20, thyroid nodule 21, 22 and, more advanced, photodynamic cancer therapy 23, 24. Since US-guided LA was applied in PTMC firstly by Papini et al 10, four more articles were written about LA 9, 17, 25, 26.…”

Thermal Ablation as an Alternative for Surgical Resection of Small (≤ 2 cm) Breast Cancers: A Meta-Analysis

“…Complete ablation rate assessment and follow-up were performed with US and mammography in the study without resection. 53 No local recurrences (0%, 95% CI, 0%-24%) were seen in 12 patients after 6 to 51 months (median 28.5 months) of follow-up with US and mammography. 53 Other Subgroup Analyses.…”

“…53 No local recurrences (0%, 95% CI, 0%-24%) were seen in 12 patients after 6 to 51 months (median 28.5 months) of follow-up with US and mammography. 53 Other Subgroup Analyses. Newer studies reported higher complete ablation rates (85.9%, 95% CI, 70%-94%) than studies performed before 2009 (40.7%, 95% CI, 5%-90%) and between 2009 and 2016 (50.0%, 26%-74%; Q = 7.06, P = .029).…”

“…A trend toward higher complete ablation rates was seen when no resection was performed 53 (96%, 95% CI, 60%-100%), compared with immediate 52 (50%, 95% CI, 26%-74%) and delayed resection (58.8%, 95% CI, 42%-86%). 17 , 30 , 51 However, subgroup analysis did not show a significant difference (Q = 4.38; P = .112) for this evaluation, nor for the comparison between histologic evaluation of the ablation zone (57.1%, 95% CI 29%-81%) and (96.2%, 95% CI 60%-100%; Q = 3.52; P = .06).…”

Ultrasound-Guided Laser Ablation After Excisional Vacuum-Assisted Breast Biopsy for Small Malignant Breast Lesions: Preliminary Results

“…Moreover, there are also studies on the laser thermal ablation of benign lesions, such as fibroadenomas 16 , 17 or as palliative therapy in inoperable or refusing surgery patients. 18 …”