Matsumoto Danielle Ramos Martin, Facina Gil
Breast surgery, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Breast surgery, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Technol Cancer Res Treat. 2025 Jan-Dec;24:15330338241300743. doi: 10.1177/15330338241300743.
We conducted a systematic review to compile the findings of all published studies on the use of percutaneous laser ablation (PLA) in the treatment of early-stage breast cancer. We aimed to identify appropriate methodology as well as parameters for the selection of suitable patients to optimize outcomes with the use of PLA. Additionally, we aimed to analyze whether this method is a viable alternative to current surgical treatments employed. The PRISMA 2020 method was applied. The terms "laser ablation" AND "breast cancer" were used to select all articles published up to January 2024 on the PubMed and Embase platforms. Articles in English were included. Only original articles were considered for this systematic review. Review articles, editorials, letters, and studies ex-vivo or not performed in humans were excluded. Seventeen articles, including 308 patients were analyzed. Among the studies describing the complete response rate to assess treatment success, there was no residual tumor after ablation in 74.4% of the patients. MRI was the best exam to evaluate the effectiveness of the ablative procedure with a NPV of 92% to 100%. Skin burn was the most commonly observed complication, occurring in 6% of patients. Other less frequent complications were hematoma/bleeding, pain, nodulation, erythema, seroma, and fat necrosis. The use of PLA remains restricted to cases with specific indications or within the context of research protocols. However, future studies may validate this promising technique for the local treatment of early-stage breast cancer. This study was registered at INPLASY (registration number: INPLASY2024100045).
我们进行了一项系统评价,以汇总所有已发表的关于经皮激光消融(PLA)治疗早期乳腺癌的研究结果。我们旨在确定合适的方法以及选择合适患者的参数,以通过使用PLA优化治疗效果。此外,我们旨在分析这种方法是否是当前采用的手术治疗的可行替代方案。应用了PRISMA 2020方法。使用“激光消融”和“乳腺癌”这两个术语在PubMed和Embase平台上筛选截至2024年1月发表的所有文章。纳入英文文章。本系统评价仅考虑原创文章。综述文章、社论、信件以及体外研究或非人体研究均被排除。分析了17篇文章,共308例患者。在描述评估治疗成功的完全缓解率的研究中,74.4%的患者消融后无残留肿瘤。MRI是评估消融手术效果的最佳检查方法,阴性预测值为92%至100%。皮肤烧伤是最常见的并发症,发生在6%的患者中。其他较不常见的并发症包括血肿/出血、疼痛、结节形成、红斑、血清肿和脂肪坏死。PLA的使用仍限于有特定适应症的病例或研究方案范围内。然而,未来的研究可能会验证这种有前景的技术用于早期乳腺癌的局部治疗。本研究已在INPLASY注册(注册号:INPLASY2024100045)。