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Radiofrequency Ablation in the Management of Liver Metastases from Breast Cancer

C. T. Sofocleous1, R. G. Nascimento1, M. Gonen2, M. Theodoulou3, A. M. Covey1, L. A. Brody1, S. M. Solomon1, R. Thornton1, Y. Fong4, G. I. Getrajdman1 and K. T. Brown1

1 Section of Interventional Radiology and Image Guided Therapies, Memorial Sloan-Kettering Cancer Center, 1275 York Ave., Rm. H118, New York, NY 10021.
2 Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY.
3 Section of Medical Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY.
4 Section of Gastrointestinal Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY.


Figure 1
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  		Fig. 1 —Graph shows primary local progression-free interval after each radiofrequency ablation session (in months). Censored patients are represented by tick marks on curve. Median was 12 months.

 

Figure 2
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  		Fig. 2 —Graph shows intervention-assisted local progression-free interval (in months) in 12 patients (six had recurrences) with an average of 1.3 sessions per patient. Censored patients are represented by tick marks on curve. Median was 47 months.

 

Figure 3
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  		Fig. 3 —Graph shows median overall survival time after radiofrequency ablation (in months) in 12 patients, four of whom died. Censored patients are represented by tick marks on curve. Median was 60 months.

 

Figure 4
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  		Fig. 4 —Graph shows median survival since initial diagnosis of breast cancer (in months) in 12 patients, four of whom died. Censored patients are represented by tick marks on curve. Median was 145 months.

 

Figure 5
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  		Fig. 5A —Example of local tumor control in 58-year-old woman with liver metastases from breast cancer. Axial contrast-enhanced CT image shows breast metastasis in left liver.

 

Figure 6
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  		Fig. 5B —Example of local tumor control in 58-year-old woman with liver metastases from breast cancer. Radiofrequency ablation probe is well positioned to provide good lesion coverage.

 

Figure 7
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  		Fig. 5C —Example of local tumor control in 58-year-old woman with liver metastases from breast cancer. Follow-up CT scans show good local tumor control is confirmed by tumor shrinkage and necrosis.

 

Figure 8
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  		Fig. 5D —Example of local tumor control in 58-year-old woman with liver metastases from breast cancer. Follow-up CT scans show good local tumor control is confirmed by tumor shrinkage and necrosis.

 

Figure 9
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  		Fig. 6A —Example of distant intrahepatic recurrence and local tumor control in 49-year-old woman with liver metastases from breast cancer. Axial T2-weighted fat-saturated MR image shows hyperintense nodular lesion in periphery of right liver. Breast metastasis is indicated by arrow.

 

Figure 10
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  		Fig. 6B —Example of distant intrahepatic recurrence and local tumor control in 49-year-old woman with liver metastases from breast cancer. Axial CT image shows well-positioned radiofrequency ablation probe providing good lesion coverage.

 

Figure 11
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  		Fig. 6C —Example of distant intrahepatic recurrence and local tumor control in 49-year-old woman with liver metastases from breast cancer. Axial contrast-enhanced CT scan 47 months after radiofrequency ablation shows good local tumor control (black arrow); however, distant intrahepatic recurrence (white arrows) is noted in left liver. Also note presence of extrahepatic metastatic disease represented by malignant pleural effusion on left side where chest tube is in place.

 

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