Ultrasound-guided microwave ablation for breast tumors: current status and future perspectives

Ultrasound (US)-guided microwave ablation (MWA) has emerged as a promising minimally invasive therapy for both benign and malignant breast tumors. This review comprehensively examines the current clinical status, technical principles, and therapeutic outcomes of US-guided MWA in breast tumor management. We discuss the biophysical mechanisms of MWA, its advantages over other ablation techniques-such as rapid temperature elevation, the ability to create more extensive coagulation areas, and diminished impact from heat sink phenomena-and the critical role of real-time US guidance in enhancing procedural precision and safety. Clinical evidence supports the efficacy of US-guided MWA in achieving high rates of complete ablation and significant volume reduction for benign tumors, such as fibroadenomas, with minimal complications and excellent cosmetic results. For early-stage breast cancers, initial studies indicate that US-guided MWA provides local tumor control comparable with surgical resection in the short- to mid-term, while also offering the benefits of shorter operation times, reduced hospitalization, and stimulation of systemic antitumor immune responses. However, challenges remain, including technical limitations in treating tumors near critical structures, the lack of long-term oncological data, and operator dependence. Future directions involve technological refinements, integration with artificial intelligence and advanced imaging, combination with immunotherapy, and standardization of protocols. US-guided MWA represents an important advancement toward personalized, organ-preserving breast tumor therapy, with ongoing innovations poised to expand its clinical applicability.