Semin intervent Radiol 2024; 41(02): 129-134
DOI: 10.1055/s-0044-1786730
Review Article

Role of Interventional Radiology in Managing Primary and Metastatic Breast Cancer

Amy R. Deipolyi
1   Interventional Radiology, Department of Surgery, WVU/Charleston Area Medical Center, Charleston, West Virginia
,
Robert C. Ward
2   Department of Diagnostic Imaging, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
› Author Affiliations

Abstract

Percutaneous image-guided locoregional therapies are emerging in the treatment of primary and metastatic breast cancer. Cryoablation has emerged as the dominant ablative approach as an alternative to surgery for primary breast cancer in patients who do not wish to have surgery or are poor surgical candidates. Cryoablation is well tolerated and provides excellent local control and cosmesis. Thermal ablation may also be used in the treatment of oligometastatic breast cancer, allowing patients to achieve long disease-free intervals. Transarterial therapies have been studied in the treatment of oligoprogressive hepatic metastasis, though further supportive data would be helpful to demonstrate its efficacy.



Publication History

Article published online:
10 July 2024

© 2024. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 American Cancer Society. Cancer Facts & Figures 2022. Atlanta, GA: American Cancer Society; 2022
  • 2 American Cancer Society. Breast Cancer Facts & Figures 2022–2024. Atlanta, GA: American Cancer Society, Inc.; 2023
  • 3 Daye D, Panagides J, Norton L. et al. New frontiers in the role of locoregional therapies in breast cancer: proceedings from the Society of Interventional Radiology Foundation Research Consensus Panel. J Vasc Interv Radiol 2023; 34 (10) 1835-1842
  • 4 Deipolyi AR, Ward RC, Riaz A. et al. Locoregional therapies for primary and metastatic breast cancer: AJR expert panel narrative review. AJR Am J Roentgenol 2024; 222 (02) e2329454
  • 5 Ward RC, Lourenco AP, Mainiero MB. Ultrasound-guided breast cancer cryoablation. AJR Am J Roentgenol 2019; 213 (03) 716-722
  • 6 Baust JG, Gage AA. The molecular basis of cryosurgery. BJU Int 2005; 95 (09) 1187-1191
  • 7 Ward RC, Lourenco AP, Mainiero MB. Implementing breast cryoablation in practice. J Breast Imaging 2020; 2 (01) 61-66
  • 8 Thai JN, Sevrukov AB, Ward RC, Monticciolo DL. Cryoablation therapy for early-stage breast cancer: evidence and rationale. J Breast Imaging 2023; 5 (06) 646-657
  • 9 Corines MJ, Sogani J, Hogan MP, Mango VL, Bryce Y. The role of contrast-enhanced mammography after cryoablation of breast cancer. AJR Am J Roentgenol 2024; 222 (02) e2330250
  • 10 Pigg N, Gordillo C, Wang Y, Ward RC. Breast cancer cryoablation with radiologic-pathologic correlation. Br J Radiol 2022; 95 (1140) 20220480
  • 11 Roubidoux MA, Sabel MS, Bailey JE, Kleer CG, Klein KA, Helvie MA. Small (< 2.0-cm) breast cancers: mammographic and US findings at US-guided cryoablation–initial experience. Radiology 2004; 233 (03) 857-867
  • 12 Littrup PJ, Jallad B, Chandiwala-Mody P, D'Agostini M, Adam BA, Bouwman D. Cryotherapy for breast cancer: a feasibility study without excision. J Vasc Interv Radiol 2009; 20 (10) 1329-1341
  • 13 Habrawi Z, Melkus MW, Khan S. et al. Cryoablation: a promising non-operative therapy for low-risk breast cancer. Am J Surg 2021; 221 (01) 127-133
  • 14 Manenti G, Perretta T, Gaspari E. et al. Percutaneous local ablation of unifocal subclinical breast cancer: clinical experience and preliminary results of cryotherapy. Eur Radiol 2011; 21 (11) 2344-2353
  • 15 Pfleiderer SO, Freesmeyer MG, Marx C, Kühne-Heid R, Schneider A, Kaiser WA. Cryotherapy of breast cancer under ultrasound guidance: initial results and limitations. Eur Radiol 2002; 12 (12) 3009-3014
  • 16 Pfleiderer SO, Marx C, Camara O, Gajda M, Kaiser WA. Ultrasound-guided, percutaneous cryotherapy of small (< or = 15 mm) breast cancers. Invest Radiol 2005; 40 (07) 472-477
  • 17 Poplack SP, Levine GM, Henry L. et al. A pilot study of ultrasound-guided cryoablation of invasive ductal carcinomas up to 15 mm with MRI follow-up and subsequent surgical resection. AJR Am J Roentgenol 2015; 204 (05) 1100-1108
  • 18 Sabel MS, Kaufman CS, Whitworth P. et al. Cryoablation of early-stage breast cancer: work-in-progress report of a multi-institutional trial. Ann Surg Oncol 2004; 11 (05) 542-549
  • 19 Simmons RM, Ballman KV, Cox C. et al; ACOSOG Investigators. A phase II trial exploring the success of cryoablation therapy in the treatment of invasive breast carcinoma: results from ACOSOG (Alliance) Z1072. Ann Surg Oncol 2016; 23 (08) 2438-2445
  • 20 Fine RE, Gilmore RC, Dietz JR. et al. Cryoablation without excision for low-risk early-stage breast cancer: 3-year interim analysis of ipsilateral breast tumor recurrence in the ICE3 trial. Ann Surg Oncol 2021; 28 (10) 5525-5534
  • 21 Khan SY, Snitman A, Habrawi Z, Crawford S, Melkus MW, Layeequr Rahman R. The role of cryoablation in breast cancer beyond the oncologic control: COST and breast-Q patient-reported outcomes. Ann Surg Oncol 2023; 30 (02) 1029-1037
  • 22 Hong K, Georgiades C. Radiofrequency ablation: mechanism of action and devices. J Vasc Interv Radiol 2010; 21 (8, Suppl): S179-S186
  • 23 Roknsharifi S, Wattamwar K, Fishman MDC. et al. Image-guided microinvasive percutaneous treatment of breast lesions: where do we stand?. Radiographics 2021; 41 (04) 945-966
  • 24 Oura S, Tamaki T, Hirai I. et al. Radiofrequency ablation therapy in patients with breast cancers two centimeters or less in size. Breast Cancer 2007; 14 (01) 48-54
  • 25 Ito T, Oura S, Nagamine S. et al. Radiofrequency ablation of breast cancer: a retrospective study. Clin Breast Cancer 2018; 18 (04) e495-e500
  • 26 Roubidoux MA, Yang W, Stafford RJ. Image-guided ablation in breast cancer treatment. Tech Vasc Interv Radiol 2014; 17 (01) 49-54
  • 27 Reyes DK, Pienta KJ. The biology and treatment of oligometastatic cancer. Oncotarget 2015; 6 (11) 8491-8524
  • 28 Pagani O, Senkus E, Wood W. et al; ESO-MBC Task Force. International guidelines for management of metastatic breast cancer: can metastatic breast cancer be cured?. J Natl Cancer Inst 2010; 102 (07) 456-463
  • 29 Gennari A, André F, Barrios CH. et al; ESMO Guidelines Committee. Electronic address: clinicalguidelines@esmo.org. ESMO Clinical Practice Guideline for the diagnosis, staging and treatment of patients with metastatic breast cancer. Ann Oncol 2021; 32 (12) 1475-1495
  • 30 Bai X-M, Yang W, Zhang ZY. et al. Long-term outcomes and prognostic analysis of percutaneous radiofrequency ablation in liver metastasis from breast cancer. Int J Hyperthermia 2019; 35 (01) 183-193
  • 31 Jakobs TF, Hoffmann RT, Schrader A. et al. CT-guided radiofrequency ablation in patients with hepatic metastases from breast cancer. Cardiovasc Intervent Radiol 2009; 32 (01) 38-46
  • 32 Meloni MF, Andreano A, Laeseke PF, Livraghi T, Sironi S, Lee Jr FT. Breast cancer liver metastases: US-guided percutaneous radiofrequency ablation–intermediate and long-term survival rates. Radiology 2009; 253 (03) 861-869
  • 33 Veltri A, Gazzera C, Barrera M. et al. Radiofrequency thermal ablation (RFA) of hepatic metastases (METS) from breast cancer (BC): an adjunctive tool in the multimodal treatment of advanced disease. Radiol Med (Torino) 2014; 119 (05) 327-333
  • 34 Liu B, Wu Z, Mo H. et al. Safety and efficacy of microwave ablation for breast cancer thoracic metastases. Cancer Manag Res 2018; 10: 5685-5689
  • 35 Meng M, Han X, Li W. et al. CT-guided microwave ablation in patients with lung metastases from breast cancer. Thorac Cancer 2021; 12 (24) 3380-3386
  • 36 Ridouani F, Solomon SB, Bryce Y, Bromberg JF, Sofocleous CT, Deipolyi AR. Predictors of progression-free survival and local tumor control after percutaneous thermal ablation of oligometastatic breast cancer: retrospective study. J Vasc Interv Radiol 2020; 31 (08) 1201-1209
  • 37 Adam R, Aloia T, Krissat J. et al. Is liver resection justified for patients with hepatic metastases from breast cancer?. Ann Surg 2006; 244 (06) 897-907 , discussion 907–908
  • 38 Bale R, Putzer D, Schullian P. Local treatment of breast cancer liver metastasis. Cancers (Basel) 2019; 11 (09) 1341
  • 39 Hagemeister Jr FB, Buzdar AU, Luna MA, Blumenschein GR. Causes of death in breast cancer: a clinicopathologic study. Cancer 1980; 46 (01) 162-167
  • 40 Hoe AL, Royle GT, Taylor I. Breast liver metastases – incidence, diagnosis and outcome. J R Soc Med 1991; 84 (12) 714-716
  • 41 Beckham TH, Yang TJ, Gomez D, Tsai CJ. Metastasis-directed therapy for oligometastasis and beyond. Br J Cancer 2021; 124 (01) 136-141
  • 42 Liberchuk AN, Deipolyi AR. Hepatic Metastasis from Breast Cancer. In: Seminars in Interventional Radiology. Thieme Medical Publishers, Inc.; 2020
  • 43 Eichler K, Jakobi S, Gruber-Rouh T, Hammerstingl R, Vogl TJ, Zangos S. Transarterial chemoembolisation (TACE) with gemcitabine: phase II study in patients with liver metastases of breast cancer. Eur J Radiol 2013; 82 (12) e816-e822
  • 44 Martin RC, Robbins K, Fagés JF. et al. Optimal outcomes for liver-dominant metastatic breast cancer with transarterial chemoembolization with drug-eluting beads loaded with doxorubicin. Breast Cancer Res Treat 2012; 132 (02) 753-763
  • 45 Cianni R, Pelle G, Notarianni E. et al. Radioembolisation with (90)Y-labelled resin microspheres in the treatment of liver metastasis from breast cancer. Eur Radiol 2013; 23 (01) 182-189
  • 46 Haug AR, Tiega Donfack BP, Trumm C. et al. 18F-FDG PET/CT predicts survival after radioembolization of hepatic metastases from breast cancer. J Nucl Med 2012; 53 (03) 371-377
  • 47 Saxena A, Meteling B, Kapoor J. et al. Yttrium-90 radioembolization is a safe and effective treatment for unresectable hepatocellular carcinoma: a single centre experience of 45 consecutive patients. Int J Surg 2014; 12 (12) 1403-1408
  • 48 Deipolyi AR, Johnson CB, Riedl CC. et al. Prospective evaluation of immune activation associated with response to radioembolization assessed with PET/CT in women with breast cancer liver metastasis. Radiology 2023; 306 (01) 279-287
  • 49 Chang J, Charalel R, Noda C. et al. Liver-dominant breast cancer metastasis: a comparative outcomes study of chemoembolization versus radioembolization. Anticancer Res 2018; 38 (05) 3063-3068