Skip to main content

Advertisement

SpringerLink
Log in

CT-Guided Radiofrequency Ablation in Patients with Hepatic Metastases from Breast Cancer

  • Clinical Investigation
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

The purpose of this study was to evaluate technical success, technique effectiveness, and survival following radiofrequency ablation for breast cancer liver metastases and to determine prognostic factors. Forty-three patients with 111 breast cancer liver metastases underwent CT-guided percutaneous radiofrequency (RF) ablation. Technical success and technique effectiveness was evaluated by performing serial CT scans. We assessed the prognostic value of hormone receptor status, overexpression of human epidermal growth factor receptor 2 (HER2), and presence of extrahepatic tumor spread. Survival rates were calculated using the Kaplan–Meier method. Technical success was achieved in 107 metastases (96%). Primary technique effectiveness was 96%. During follow-up local tumor progression was observed in 15 metastases, representing a secondary technique effectiveness of 86.5%. The overall time to progression to the liver was 10.5 months. The estimated overall median survival was 58.6 months. There was no significant difference in terms of survival probability with respect to hormone receptor status, HER2 overexpression, and presence of isolated bone metastases. Survival was significantly lower among patients with extrahepatic disease, with the exception of skeletal metastases. We conclude that CT-guided RF ablation of liver metastases from breast cancer can be performed with a high degree of technical success and technique effectiveness, providing promising survival rates in patients with no visceral extrahepatic disease. Solitary bone metastases did not negatively affect survival probability after RF ablation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Jardines L, Callans LS, Torosian MH (1993) Recurrent breast cancer: presentation, diagnosis, and treatment. Semin Oncol 20(5):538–547

    PubMed  CAS  Google Scholar 

  2. Gregory WM, Smith P, Richards MA et al (1993) Chemotherapy of advanced breast cancer: outcome and prognostic factors. Br J Cancer 68(5):988–995

    PubMed  CAS  Google Scholar 

  3. Miller KD, Sledge GW Jr (1999) The role of chemotherapy for metastatic breast cancer. Hematol Oncol Clin North Am 13(2):415–434

    Article  PubMed  CAS  Google Scholar 

  4. Stockler M, Wilcken NR, Ghersi D et al (2000) Systematic reviews of chemotherapy and endocrine therapy in metastatic breast cancer. Cancer Treat Rev 26(3):151–168

    Article  PubMed  CAS  Google Scholar 

  5. Hoe AL, Royle GT, Taylor I (1991) Breast liver metastases—incidence, diagnosis and outcome. J R Soc Med 84(12):714–716

    PubMed  CAS  Google Scholar 

  6. Zinser JW, Hortobagyi GN, Buzdar AU et al (1987) Clinical course of breast cancer patients with liver metastases. J Clin Oncol 5(5):773–782

    PubMed  CAS  Google Scholar 

  7. Adam R, Aloia T, Krissat J et al (2006) Is liver resection justified for patients with hepatic metastases from breast cancer? Ann Surg 244(6):897–907

    Article  PubMed  Google Scholar 

  8. Carlini M, Lonardo MT, Carboni F et al (2002) Liver metastases from breast cancer. Results of surgical resection. Hepatogastroenterology 49(48):1597–1601

    PubMed  Google Scholar 

  9. Maksan SM, Lehnert T, Bastert G et al (2000) Curative liver resection for metastatic breast cancer. Eur J Surg Oncol 26(3):209–212

    Article  PubMed  CAS  Google Scholar 

  10. Raab R, Nussbaum KT, Behrend M et al (1998) Liver metastases of breast cancer: results of liver resection. Anticancer Res 18(3C):2231–2233

    PubMed  CAS  Google Scholar 

  11. Selzner M, Morse MA, Vredenburgh JJ et al (2000) Liver metastases from breast cancer: long-term survival after curative resection. Surgery 127(4):383–389

    Article  PubMed  CAS  Google Scholar 

  12. Vlastos G, Smith DL, Singletary SE et al (2004) Long-term survival after an aggressive surgical approach in patients with breast cancer hepatic metastases. Ann Surg Oncol 11(9):869–874

    Article  PubMed  Google Scholar 

  13. Konecny GE, Thomssen C, Luck HJ et al (2004) Her-2/neu gene amplification and response to paclitaxel in patients with metastatic breast cancer. J Natl Cancer Inst 96(15):1141–1151

    Article  PubMed  CAS  Google Scholar 

  14. Imkampe A, Bendall S, Bates T (2007) The significance of the site of recurrence to subsequent breast cancer survival. Eur J Surg Oncol 33(4):420–423

    Article  PubMed  CAS  Google Scholar 

  15. Goldberg SN, Gazelle GS, Compton CC et al (2000) Treatment of intrahepatic malignancy with radiofrequency ablation: radiologic-pathologic correlation. Cancer 88(11):2452–2463

    Article  PubMed  CAS  Google Scholar 

  16. Paulet E, Aube C, Pessaux P et al (2008) Factors limiting complete tumor ablation by radiofrequency ablation. CardioVasc Interv Radiol 31(1):107–115

    Article  Google Scholar 

  17. Rahman ZU, Frye DK, Smith TL et al (1999) Results and long term follow-up for 1581 patients with metastatic breast carcinoma treated with standard dose doxorubicin-containing chemotherapy: a reference. Cancer 85(1):104–111

    Article  PubMed  CAS  Google Scholar 

  18. Bergh J, Jonsson PE, Glimelius B et al (2001) A systematic overview of chemotherapy effects in breast cancer. Acta Oncol 40(2–3):253–281

    Article  PubMed  CAS  Google Scholar 

  19. Cristofanilli M, Hortobagyi GN (2001) New horizons in treating metastatic disease. Clin Breast Cancer 1(4):276–287

    Article  PubMed  CAS  Google Scholar 

  20. O’Reilly SM, Richards MA, Rubens RD (1990) Liver metastases from breast cancer: the relationship between clinical, biochemical and pathological features and survival. Eur J Cancer 26(5):574–577

    PubMed  CAS  Google Scholar 

  21. Jakobs TF, Hoffmann RT, Trumm C et al (2006) Radiofrequency ablation of colorectal liver metastases: mid-term results in 68 patients. Anticancer Res 26(1B):671–680

    PubMed  Google Scholar 

  22. Lencioni R, Crocetti L, Cioni D et al (2004) Percutaneous radiofrequency ablation of hepatic colorectal metastases: technique, indications, results, and new promises. Invest Radiol 39(11):689–697

    Article  PubMed  Google Scholar 

  23. Lencioni R, Cioni D, Crocetti L et al (2005) Early-stage hepatocellular carcinoma in patients with cirrhosis: long-term results of percutaneous image-guided radiofrequency ablation. Radiology 234(3):961–967

    Article  PubMed  Google Scholar 

  24. Livraghi T, Goldberg SN, Lazzaroni S et al (1999) Small hepatocellular carcinoma: treatment with radio-frequency ablation versus ethanol injection. Radiology 210(3):655–661

    PubMed  CAS  Google Scholar 

  25. Livraghi T, Goldberg SN, Lazzaroni S et al (2000) Hepatocellular carcinoma: radio-frequency ablation of medium and large lesions. Radiology 214(3):761–768

    PubMed  CAS  Google Scholar 

  26. Livraghi T, Solbiati L, Meloni F et al (2003) Percutaneous radiofrequency ablation of liver metastases in potential candidates for resection: the “test-of-time approach”. Cancer 97(12):3027–3035

    Article  PubMed  Google Scholar 

  27. Parkin DM, Bray FI, Devesa SS (2001) Cancer burden in the year 2000. The global picture. Eur J Cancer 37(Suppl 8):S4–S66

    Article  PubMed  Google Scholar 

  28. Lawes D, Chopada A, Gillams A et al (2006) Radiofrequency ablation (RFA) as a cytoreductive strategy for hepatic metastasis from breast cancer. Ann R Coll Surg Engl 88(7):639–642

    Article  PubMed  CAS  Google Scholar 

  29. Livraghi T, Goldberg SN, Solbiati L et al (2001) Percutaneous radio-frequency ablation of liver metastases from breast cancer: initial experience in 24 patients. Radiology 220(1):145–149

    PubMed  CAS  Google Scholar 

  30. Gunabushanam G, Sharma S, Thulkar S et al (2007) Radiofrequency ablation of liver metastases from breast cancer: results in 14 patients. J Vasc Interv Radiol 18(1; Pt 1):67–72

    Article  PubMed  Google Scholar 

  31. Lencioni R (2004) Tumor Radiofrequency Ablation Italian Network (TRAIN): survival analysis in breast cancer patients with isolated hepatic metastases. 2004 Assembly of the Radiological Society of North America, Chicago, IL

  32. Hortobagyi GN, Smith TL, Legha SS et al (1983) Multivariate analysis of prognostic factors in metastatic breast cancer. J Clin Oncol 1(12):776–786

    PubMed  CAS  Google Scholar 

  33. Perez JE, Machiavelli M, Leone BA et al (1990) Bone-only versus visceral-only metastatic pattern in breast cancer: analysis of 150 patients. A GOCS study. Grupo Oncologico Cooperativo del Sur. Am J Clin Oncol 13(4):294–298

    Article  PubMed  CAS  Google Scholar 

  34. Leone BA, Romero A, Rabinovich MG et al (1988) Stage IV breast cancer: clinical course and survival of patients with osseous versus extraosseous metastases at initial diagnosis. The GOCS (Grupo Oncologico Cooperativo del Sur) experience. Am J Clin Oncol 11(6):618–622

    Article  PubMed  CAS  Google Scholar 

  35. Muss HB (1992) Endocrine therapy for advanced breast cancer: a review. Breast Cancer Res Treat 21(1):15–26

    Article  PubMed  CAS  Google Scholar 

  36. Rowlings PA, Williams SF, Antman KH et al (1999) Factors correlated with progression-free survival after high-dose chemotherapy and hematopoietic stem cell transplantation for metastatic breast cancer. JAMA 282(14):1335–1343

    Article  PubMed  CAS  Google Scholar 

  37. Rizzieri DA, Vredenburgh JJ, Jones R et al (1999) Prognostic and predictive factors for patients with metastatic breast cancer undergoing aggressive induction therapy followed by high-dose chemotherapy with autologous stem-cell support. J Clin Oncol 17(10):3064–3074

    PubMed  CAS  Google Scholar 

  38. Mack MG, Straub R, Eichler K et al (2004) Breast cancer metastases in liver: laser-induced interstitial thermotherapy—local tumor control rate and survival data. Radiology 233:400

    Article  PubMed  Google Scholar 

  39. Adam R, Aloia T, Krissat J et al (2006) Is liver resection justified for patients with hepatic metastases from breast cancer? Ann Surg 244(6):897–908

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Ludwig-Maximilians-University of Munich, Campus Grosshadern, Marchioninistrasse 15, 81377, Munich, Germany

    Tobias F. Jakobs, Ralf-Thorsten Hoffmann, Angelika Schrader, Christoph Trumm & Maximilian F. Reiser

  2. Department of Internal Medicine III, Ludwig-Maximilians-University of Munich, Campus Grosshadern, Marchioninistrasse 15, 81377, Munich, Germany

    Hans Joachim Stemmler

  3. Department of Radiology, University of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany

    Andreas Lubienski

  4. Division of Diagnostic Imaging, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, USA

    Ravi Murthy

  5. Department of Radiology, Klinikum Bogenhausen, Englschalkinger Str. 77, 81925, Munich, Germany

    Thomas K. Helmberger

Authors
  1. Tobias F. Jakobs
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ralf-Thorsten Hoffmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Angelika Schrader
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hans Joachim Stemmler
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Christoph Trumm
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Andreas Lubienski
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ravi Murthy
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Thomas K. Helmberger
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Maximilian F. Reiser
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tobias F. Jakobs.

Additional information

Drs. Jakobs and Hoffmann contributed equally to this article.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Jakobs, T.F., Hoffmann, RT., Schrader, A. et al. CT-Guided Radiofrequency Ablation in Patients with Hepatic Metastases from Breast Cancer. Cardiovasc Intervent Radiol 32, 38–46 (2009). https://doi.org/10.1007/s00270-008-9384-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00270-008-9384-7

Keywords

Search

Navigation