Minimally Invasive Treatments for Breast Cancer

Interventional Radiology Treatments Offer New Options and Hope to Patients Who Are Not Good Surgical Candidates

Procedures performed by interventional radiologists are being increasingly used in the care of patients with cancer. These specially trained physicians use X-rays, ultrasound or other imaging techniques to guide small tubes called catheters and miniature tools directly to the site of the disease. Interventional radiology procedures for patients with cancer include new approaches for treatment, relieving pain and diagnosing cancer without surgical biopsy.

Breast Cancer

In the United States, a woman is diagnosed with breast cancer every three minutes and one woman will die from the disease every 13 minutes. For these women, as well as the thousands of men diagnosed each year, breast cancer treatments can be highly effective, but often require invasive treatment options such as surgery and chemotherapy. Recent advancements in technology and imaging now offer patients more tools to fight breast cancer--minimally invasive treatments known as thermal ablation and laser therapy.

Thermal ablation treatment builds on the two-decade trend toward less radical approaches and utilizes local treatments for breast cancer. Due to the cosmetic result of more invasive therapies, treatments that would preserve the greatest amount of normal tissue (breast conservation) have great appeal. Although the devices used in radiofrequency ablation, cryoablation and laser therapy are FDA approved, more research and long-term data are needed to determine the role these procedures will have in the fight against breast cancer.

Surgery offers the best chance for a cure. Until long-term data are available, interventional treatments are reserved for women who cannot have surgery.

Breast Cancer Growth

When breast tissue divides and grows at an abnormal rate, a mass of extra tissue can develop into a tumor. To continue growing, a tumor generates its own blood supply to provide oxygen and nutrients. Although the cancerous cells can grow in size in the breast, they can also travel throughout a person's blood stream and become embedded in other organs, a process known as metastasis. Typically, 20 percent of breast cancer develops in the lobules where milk is produced, while 80 percent originates in the mammary ducts that carry milk from the lobules to the nipple.

As vascular experts, interventional radiologists are uniquely skilled in using the vascular system to deliver targeted treatments via catheter throughout the body. In treating cancer patients, interventional radiologists can attack the cancer tumor from inside the body without medicating or affecting other parts of the body. For breast cancer, interventional radiologists use thermal ablation, as well as some laser therapy, to kill the cancer cells. Although the devices used are FDA approved, research to evaluate the long-term effects of these treatments is ongoing.

Prevalence

* In the United States, a woman has about a 13% lifetime risk of developing breast cancer.

* Women 50 years of age and older account for approximately 80 percent of all breast cancers.

* Between age 40 and 50 the incidence of breast cancer doubles, and by age 70 it doubles again.

* In the United States, African Americans have the highest death rate from breast cancer compared to any other racial group.

* Breast cancer is the most common cancer among women.

* In American women, the breast is the leading cancer site and is second only to lung cancer in deaths.

Metastatic Cancer

Patients with invasive breast cancer are at risk for liver cancer. The liver serves as a way-station for cancer cells that circulate through the bloodstream. These cells may grow and form tumors in the liver. It is estimated that as many as 70 percent of all people with uncontrolled cancer will eventually develop secondary liver tumors, or metastases (tumors formed by primary cancer cells that have spread from other cancer sites). Interventional radiologists offer nonsurgical treatments for liver cancer, including embolization to cut off the blood supply to the tumor, radioembolization that delivers radiation directly inside the tumor, and chemoembolization, which delivers the cancer drug directly into the tumor and then cuts off the blood supply.