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Clinical Efficacy of Percutaneous Image-Guided Ablation in Breast Cancer Metastases to the Liver
by
, , ,
Govindarajan Narayanan
1,2,3, 
Elizabeth Mary Ruiz
2,3
,
Madelon Dijkstra
4,
Nicole T. Gentile
2,3,
Danielle Donahue
2,3,5,
Ripal T. Gandhi
1,2,3,
Reshma L. Mahtani
6,
Starr Mautner
7 and
Bente A. T. van den Bemd
2,3,4,* 1
Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA
2
Department of Interventional Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL 33176, USA
3
Department of Interventional Radiology, Miami Cardiac and Vascular Institute, Baptist Health South Florida, Miami, FL 33176, USA
4
Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location VUmc, Cancer Center Amsterdam, 1081 HV Amsterdam, The Netherlands
5
Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL 33314, USA
6
Department of Breast Medical Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL 33176, USA
7
Department of Breast Surgical Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL 33176, USA
*
Author to whom correspondence should be addressed.
Cancers 2025, 17(23), 3823; https://doi.org/10.3390/cancers17233823 (registering DOI)
Submission received: 22 October 2025
/
Revised: 24 November 2025
/
Accepted: 27 November 2025
/
Published: 28 November 2025
(This article belongs to the Special Issue Image-Guided Treatment of Liver Tumors)
Simple Summary
This study focuses on evaluating the clinical efficacy and safety of percutaneous ablation techniques, specifically microwave ablation (MWA) and irreversible electroporation (IRE), as treatment options for patients with liver metastases from breast cancer (BCLM) who are not eligible for surgery. While systemic therapies are standard for BCLM, patients with limited liver disease or progression under treatment may benefit from local therapies that can help control the disease, delay progression, and improve survival. The study finds that percutaneous ablation shows promising disease control and a favorable safety profile, with relatively low complication rates and good survival outcomes compared to other treatments. These results support further exploration of percutaneous ablation as a potential alternative in managing liver-dominant BCLM.
Abstract
Objectives: This single-center retrospective study evaluates the clinical efficacy and safety of percutaneous ablation using microwave ablation (MWA) and irreversible electroporation (IRE) in patients with breast cancer liver metastases (BCLM). Methods: Between August 2018 and December 2023, 32 patients underwent 40 image-guided ablations for 57 BCLM. Mean age was 61.3 years (range: 32–85), and mean tumor size was 2.9 cm (range: 0.9–7.0 cm). Fifty lesions were treated with MWA and seven with IRE. Clinical efficacy was assessed by m-RECIST response at first follow-up imaging (after ≥1 month) and by monitoring local tumor progression (LTP), local tumor progression-free survival (LTPFS), and overall survival (OS). Safety was evaluated by adverse events according to CTCAE. Kaplan–Meier statistics were used for LTPFS and OS. Results: Median follow-up was 32.4 months (95% CI 16.6–48.0). Complete response was observed in 34 tumors (59.6%), partial response in 14 (24.6%), and progressive disease in 9 (15.8%). LTP occurred in 37 tumors (64.9%), with a median time to progression of 11.1 months (95% CI 1.4–20.8). One- and two-year LTPFS rates were 43.6% and 34.1%. Sixteen patients died during follow-up, with median OS of 27.8 months (95% CI 19.0–36.6) and 1- and 2-year OS rates of 90.1% and 55.9%. No major complications occurred. Complications included eight Grade 1 and two Grade 2 complications. Conclusions: Percutaneous ablation demonstrates clinical efficacy and a favorable safety profile in selected BCLM patients, achieving OS comparable to the current literature. Further studies should clarify its additive role within multimodality treatment.
