Thermal ablation is a minimally invasive procedure in which tumours are destroyed with very high (microwave ablation, radiofrequency ablation, radiofrequency ultrasound ablation and laser ablation) or low (cryoablation) temperatures. The aim of this report was to investigate whether thermal ablation procedures are as or more effective and safer than standard surgery for early-stage breast cancer.

For this purpose, a total of 19 studies on the various ablation techniques were identified.
Comparative evidence was only available for cryoablation, radiofrequency ablation and microwave ablation. Results with low to very low-certainty evidence suggest that these treatments have comparable effectiveness and are generally safe. However, there is a risk that these results may have been influenced by tumour resection and adjuvant therapies. To establish thermal ablation as a viable alternative to surgery, high-quality, long-term RCTs with standardised methods and non-inferiority studies are essential.