Microwave ablation for breast cancer liver metastasis

Background: Prognosis of patients with Breast Cancer Liver metastases (BCLMs) is dismal. Retrospective data support the role of adjuvant surgery in selected patients. Ablative treatments are a minimally invasive but their role in the management of BCLMs still remains controversial. Methods: A retrospective analysis of patients who underwent laparoscopic or percutaneous microwave ablation (MWA) between January 2009 and December 2016 at a single center was made. Analysis was performed in a nodule-oriented and patient-oriented base. Post-procedural complications were recorded according to the Clavien-Dindo classification. Radiologic scan review was centralized. Results: Thirty-four patients presented with 60 nodules with median number of nodules of 1 per patient (range 1-6). Ablations were carried out 17 percutaneously and 17 laparoscopically. Median tumor size was 26mm (range 10-80). Median patient age was 53years (range 30-81). Median time from breast cancer to metastases was 50 months (range 0-184). Median single ablation time was 10 min (range 3-46). Median length of hospital stay was 1 day (range 1-9). Complete ablation, evaluated at 1 month, was achieved in 85% of nodules and in 75% of patients. Complication rate (Grade I or II) was 20.5% with no major complications recorded and no death at 90-days. Conclusion: Minimally invasive MWA is safe, effective and feasible. In selected cases it could play a role as adjuvant treatment. Patients may benefit from locoregional therapy as a part of a multi-modal treatment.