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Review
. 2024 May 7;97(1157):886-893.
doi: 10.1093/bjr/tqae028.

Minimally invasive treatment of early, good prognosis breast cancer-is this feasible?

Mhairi Mactier  1 , Stuart A McIntosh  2 , Nisha Sharma  3
Affiliations
Review

Minimally invasive treatment of early, good prognosis breast cancer-is this feasible?

Mhairi Mactier et al. Br J Radiol. .

Abstract

Breast cancer screening programmes frequently detect early, good prognosis breast cancers with significant treatment burden for patients, and associated health-cost implications. Emerging evidence suggests a role for minimally invasive techniques in the management of these patients enabling many women to avoid surgical intervention. Minimally invasive techniques include vacuum-assisted excision, cryoablation, and radiofrequency ablation. We review published evidence in relation to the risks and benefits of each technique and discuss ongoing trials. Data to date are promising, and we predict a trend towards minimally invasive treatment for early, good-prognosis breast cancer as technical skills, suitability criteria, and follow-up protocols are established.

Keywords: breast cancer; breast screening; cryotherapy; minimally invasive surgery; radiofrequency ablation; vacuum-assisted excision.

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Conflict of interest statement

S.M. reports honoraria from MSD, Roche, BD, Novartis, Lilly, and Astra Zeneca; conference travel and support from Roche, Lilly, and MSD, and institutional research funding from Novartis and Almac Diagnostic Services. S.M. reports grant funding from Cancer Research UK, the National Institute for Health Research (including as Chief Investigator for the SMALL trial) and Breast Cancer Now. The other authors have no conflicts to declare.

Figures

Figure 1.
Figure 1.
Step-by-step ultrasound-guided vacuum-assisted excision of a fibroadenoma. (A) solid hypoechoic lesion, with regular shape and a circumscribed margin (B, C) US guided 8G vacuum-assisted excised (D) lesion has been completed removed and metallic marker clip release (E) axial follow-up scan at 12 months (F) longitudinal follow-up scan at 12 months.
Figure 2.
Figure 2.
(1) 1.1 cm grade II ER/HR+ HER2-intraductal carcinoma (2 and 3) long-axis and short-axis view of cryoprobe placement within the tumour [arrowhead denotes edge of tumour; caliper (+) denotes cryoprobe tip] (4) long-axis view of ice ball (*) enveloping the tumour. Adapted from Regen-Tuero et al.
Figure 3.
Figure 3.
(Left) MRI before RFA; (Right) MRI after RFA.
See this image and copyright information in PMC

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