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Journal Information
Vol. 53. Issue 3.
Pages 226-235 (January 2011)
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Vol. 53. Issue 3.
Pages 226-235 (January 2011)
DOI: 10.1016/S2173-5107(11)70012-X
Review of interventional radiology techniques in breast disease
Actualización en intervencionismo mamario terapéutico
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L. Apesteguia Ciriza??
Corresponding author
lapestec@navarra.es

Corresponding author.
, A. Ovelar Ferrero, C. Alfaro Adrián
Departamento de Radiología, Complejo Hospitalario de Navarra, Pamplona, Spain
Article information
Abstract

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.

Keywords:
Radiofrequency
Ablation
Laser therapy
Focused ultrasound
Resumen

La radiología mamaria tiene una vertiente terapéutica importante. La ultrasonografía, para drenar colecciones, la biopsia de vacío para extirpar papilomas y fibroadenomas y la biopsia estereotáxica escisional, son ejemplos.

Existe creciente interés por el tratamiento mínimamente invasivo de tumores infiltrantes, buscando similar efectividad con menor morbilidad y mejor resultado cosmético. Destacan las técnicas de ablación térmica, que consisten en destruir tumores mediante calor o frío. Las más estudiadas son: radiofrecuencia, ultrasonidos focalizados, laserterapia, microondas y crioablación.

Hemos revisado las publicaciones existentes. El desarrollo de estas terapias dependerá sustancialmente de la capacidad de las técnicas de imagen para planificar la destrucción tumoral. Ultrasonografía y resonancia magnética son actualmente las técnicas de elección.

Existe evidencia de que el carcinoma infiltrante pequeño puede ser eficazmente tratado mediante termoablación, particularmente por radiofrecuencia, pero antes de validarla, serán necesarios ensayos clínicos fase III, comparándola con la cirugía conservadora, en términos de progresión local y supervivencia global.

Palabras clave:
Radiofrecuencia
Ablación
Laserterapia
Ultrasonidos focalizados

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