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Abstract
Breast surgery maintains a central role in achieving local disease control in the management of breast cancer. After the introduction of radical mastectomy as a standard treatment technique, there has been a continuing shift toward decreasing the amount of tissue removed during surgery, especially for the treatment of small cancers. Breast conservative treatment has been increasingly used because it has demonstrated survival rates similar to those of the more radical treatments. These treatments also have the added advantage of resulting in a more-natural appearing breast after cosmetic surgery. In fact, the current standard treatment for T1N0M0 tumors is lumpectomy followed by radiation therapy. Over the past decade, a number of new, minimally invasive image-guided techniques have been developed that allow the insertion of needle-shaped devices into the tumor to completely and percutaneously destroy, or ablate, the cells using cold or heat. These techniques have demonstrated their efficacy and are being routinely used in the treatment of diverse tumors, especially in liver, kidney, lung, or bone. Ablative techniques allow parenchyma-sparing treatment of tumors. In addition, in patients who are not candidates for surgery, percutaneous ablation allows local treatment with lower morbidity and mortality. Therefore, this approach could increase the number of patients who are candidates for treatment. Ablative techniques may be considered alone or in conjunction with resection. Radiofrequency (RF) ablation is the most widely used of these techniques.
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CHAPTER 14
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