Review of interventional radiology techniques in breast disease

Breast imaging plays a significant role in treatment. Ultrasonography to drain fluid collections, vacuum-assisted biopsy to excise papillomas and fibroadenomas, and stereotactic excisional biopsy are a few examples of interventional procedures performed by radiologists in patients with breast disease. Moreover, there is a growing interest in the minimally invasive treatment of invasive tumors, which aims to achieve the same efficacy while minimizing morbidity and improving the esthetic outcome. Especially noteworthy are thermal ablation techniques, which involve destroying tumors with heat or cold. The most widely studied thermal ablation techniques are radiofrequency, high intensity focused ultrasound, laser therapy, microwaves, and cryoablation. After a review of the literature, we conclude that the development of these treatment approaches will depend largely on the capacity of imaging techniques to plan the destruction of the tumor. Ultrasonography and magnetic resonance imaging are the current techniques of choice for this purpose. The evidence suggests that small invasive carcinomas can be efficaciously treated with thermal ablation, especially by radiofrequency ablation; however, before this technique can be validated, phase III clinical trials must compare it with conservative surgery in terms of local progression and overall survival. (C) 2010 SERAM. Published by Elsevier Espana, S.L. All rights reserved.