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Breast Cancer — Embolization or Chemoembolization: treatment in the Best Hospitals in the World

University Hospital Rechts der Isar Munich

9.8/10
location_onGermany, Munich

Department of Interventional Radiology

The Department of Interventional Radiology offers the full range of imaging examinations, as well as innovative image-guided minimally invasive techniques for the treatment of tumors, vascular diseases and internal pathologies (for example, CT, MRI, PET-CT, SPECT). The department's doctors have deep knowledge and colossal experience in the field of interventional radiological methods of treatment, which represent an excellent alternative to open surgical interventions. Despite the high level of technical equipment and the presence of advanced computerized systems, the focus is always on the person with his individual needs. Compliance with current clinical protocols and high professionalism of the department's specialists contribute to the successful clinical practice, as well as the reputability of the department among the best medical facilities of this kind in Germany.

University Hospital Halle (Saale)

9.6/10
location_onGermany, Halle

Department of Adult and Pediatric Diagnostic, Interventional Radiology, Neuroradiology

The Department of Adult and Pediatric Diagnostic, Interventional Radiology, Neuroradiology offers the full range of modern radiological diagnostics and minimally invasive treatment both on an inpatient and outpatient basis. It has advanced equipment for conducting radiological studies in adults and children, as well as minimally invasive procedures under the guidance of imaging systems. There is maintained close cooperation with many departments of the hospital, which provides an interdisciplinary approach to treatment and comprehensive medical care.

University Hospital Muenster

9.8/10
location_onGermany, Muenster

Department of Adult and Pediatric Diagnostic, Interventional Radiology, Neuroradiology

The Department of Adult and Pediatric Diagnostic, Interventional Radiology, Neuroradiology is one of the best institutions of its kind in Germany and offers patients the full range of radiological studies and imaging-guided minimally invasive therapy. The department’s scope of tasks also includes imaging diagnostics in children of all age groups, detection and invasive treatment of cerebral vascular pathology (neuroradiology). Patient care is provided both on an inpatient and outpatient basis.

HELIOS University Hospital Wuppertal

9.8/10
location_onGermany, Wuppertal

Department of Neuroradiology

The Department of Neuroradiology provides the full range of diagnostic and therapeutic services in the areas of ​​its specialization. The team of the department's doctors deals with the diagnostics and treatment of brain and spinal cord pathologies. The department has at its disposal state-of-the-art medical equipment, including systems for CT, MRI and myelography, thanks to which specialists can comprehensively assess the state of the nervous system, detect pathological processes at the initial stages and provide effective treatment. Among the department's therapeutic options, a special focus is on the interventional treatment of acute stroke – thrombectomy. Another important focus of the specialists' work is the treatment of cerebral vascular malformations, stenosis of the arteries of the brain and spinal cord, and cerebral aneurysms. In addition, the department provides CT-guided interventional pain management to relieve chronic back pain. The department's neuroradiologists cooperate closely with doctors from the related medical specialties: neurologists, neurosurgeons, ophthalmologists, otolaryngologists and radiation therapists. The specialists strive to provide each patient with high quality medical care meeting his needs and wishes.

University Hospital Oldenburg

10/10
location_onGermany, Oldenburg

Department of Adult and Pediatric Diagnostic, Interventional Radiology

The Department of Adult and Pediatric Diagnostic, Interventional Radiology offers the full range of services in these medical fields. To ensure the accurate diagnostics and effective treatment, the department has state-of-the-art medical equipment, particularly 64-slice CT scanner, two 1.5 Tesla high-performance MRI devices, modern equipment for digital subtraction angiography (DSA), pulsed fluoroscopy and many other devices. All medical services are carried out in strict accordance with the protocols of professional societies.

Charite University Hospital Berlin

9/10
location_onGermany, Berlin

Department of Adult and Pediatric Diagnostic, Interventional Radiology

The Department of Adult and Pediatric Diagnostic, Interventional Radiology offers the full range of medical services in these fields. In order to ensure the most accurate and reliable diagnostics, the department has state-of-the-art systems for CT, MRI, PET, ultrasound and X-ray examinations, as well as PET-CT and SPECT-CT hybrid examinations. The department specializes in interventional radiology, namely, imaging-guided therapy. It performs all vascular (for example, vascular recanalization) and non-vascular imaging-guided interventions (for example, tumor ablation). The department is one of the largest and leading medical facilities of this kind in Europe.

University Hospital Saarland Homburg

9.8/10
location_onGermany, Homburg

Department of Diagnostic and Interventional Neuroradiology

The Department of Diagnostic and Interventional Neuroradiology offers the full range of services in this medical field. Of particular interest are interventional procedures for the treatment of acute and chronic vascular diseases, such as ischemic strokes, cerebral hemorrhages, cerebral artery stenosis or vascular malformations. To ensure comprehensive medical care, there is maintained close cooperation with the Departments of Neurology and Neurosurgery.

University Hospital Ulm

8.7/10
location_onGermany, Ulm

Department of Adult and Pediatric Diagnostic, Interventional Radiology, Neuroradiology

The Department of Adult and Pediatric Diagnostic, Interventional Radiology, Neuroradiology offers the  full range of modern radiological studies and imaging-guided minimally invasive therapy for the treatment of various diseases. Of particular interest to the experienced medical team of the department is individual minimally invasive therapy of oncological diseases, treatment of pain syndromes and vascular pathology. The department works in close cooperation with all other departments of the hospital, thereby providing interdisciplinary, comprehensive medical care at the highest level of university medicine.

University Hospital Frankfurt am Main

10/10
location_onGermany, Frankfurt am Main

Department of Adult and Pediatric Diagnostic, Interventional Radiology

The Department of Adult and Pediatric Diagnostic, Interventional Radiology provides the full range of services in these fields and specializes in conducting radiologic examinations, high-intensity focused ultrasound (HIFU) therapy, vascular, oncological, orthopedic and urologic interventions. The department includes specialized Sections for Gynecologic, Pediatric and Orthopedic Radiology.

University Hospital Duesseldorf

9.45/10
location_onGermany, Duesseldorf

Department of Adult and Pediatric Diagnostic Radiology, Interventional Radiology and Neuroradiology

The Department of Adult and Pediatric Diagnostic Radiology, Interventional Radiology and Neuroradiology offers the full range of modern radiological examinations and minimally invasive imaging-guided treatment of various diseases. Most often, radiologists have to deal with the diagnostics and therapy of tumors, inflammatory processes, injuries, pathologies of the heart and vascular diseases. The combination of advanced medical technologies and high professionalism of the doctors working in the department are the key to the successful treatment results.

University Hospital Jena

9.5/10
location_onGermany, Jena

Department of Adult and Pediatric Diagnostic, Interventional Radiology, Neuroradiology

The Department of Adult and Pediatric Diagnostic, Interventional Radiology, Neuroradiology offers the full range of services in these medical fields. Here patients can undergo all modern imaging diagnostic studies and therapeutic procedures, the quality of which corresponds to high international standards. The department also specializes in conducting radiological studies in children and adolescents. The cutting-edge technical equipment and the rich clinical experience of doctors contribute to the successful work of the department.

University Hospital Tuebingen

9.13333/10
location_onGermany, Tuebingen

Department of Adult and Pediatric Diagnostic Radiology, Interventional Radiology

The Department of Adult and Pediatric Diagnostic Radiology, Interventional Radiology offers the full range of services in these fields. It conducts all types of modern imaging studies: sonography, digital X-ray, angiography, multilayer computed tomography and conventional MRI, positron emission tomography (PET/CT), etc. The department also specializes in minimally invasive treatment of various tumors, vascular pathology (obstruction and vascular stenosis). The Section of Experimental Radiology is engaged in active research to optimize existing methods and develop new ones.

University Hospital Würzburg

9.8/10
location_onGermany, Würzburg

Department of Adult and Pediatric Diagnostic, Interventional Radiology

The Department of Adult and Pediatric Diagnostic, Interventional Radiology offers the full range of modern diagnostic and therapeutic procedures in this field. For this purpose, it has advanced medical equipment: magnetic resonance imaging (MRI), multispiral computed tomography (CT), duplex sonography and digital X-ray, fluoroscopy, etc. In the field of interventional radiology, the focus is on the treatment of vascular diseases, for example, the doctors of the department conduct special measures for dilating the vessels in peripheral arterial occlusive disease and closing the vessels in complicated bleedings. Also, the range of services in this field is complemented by the installation of drainage and port systems, punctures, and special percutaneous methods for tumor treatment.

University Hospital Heidelberg

9.8/10
location_onGermany, Heidelberg

Department of Adult and Pediatric Diagnostic, Interventional Radiology

The Department of Adult and Pediatric Diagnostic, Interventional Radiology offers the full range of services in these medical fields. It conducts all modern radiological examinations and imaging-guided minimally invasive interventions for the treatment of various benign and malignant diseases. A feature of the department is imaging diagnostics in children and adolescents. There are specially adapted devices with minimal irradiation for this purpose.

Helios Hospital Hildesheim

9.5/10
location_onGermany, Hildesheim

Department of Interventional Radiology

The Department of Interventional Radiology provides the full range of medical services in the area of its specialization. The team of the department's doctors specializes in diagnostic and therapeutic image-guided interventional procedures. The doctors have at their disposal the most advanced imaging devices, including X-ray systems, ultrasound devices, equipment for computed tomography and magnetic resonance imaging. In most cases, the department's specialists perform interventions on the vessels, and therefore doctors from the Department of Vascular Surgery are often involved in the therapeutic process. The use of state-of-the-art equipment allows the patients to get rid of pathological changes in the vessels of any part of the body, excluding open invasive surgery with its high risks. The department's medical staff has excellent qualifications and vast clinical experience, so patients confidently trust their health to real professionals.

University Hospital Carl Gustav Carus Dresden

8.70435/10
location_onGermany, Dresden

Department of Neuroradiology

The Department of Neuroradiology offers the full range of imaging diagnostics and minimally invasive image-guided therapy for patients with nervous system diseases. The department's medical team specializes in care for pathologies of the brain, spinal cord, peripheral nerves and muscles. The department has state-of-the-art systems for computed tomography (CT) and magnetic resonance imaging (MRI), which provide doctors with information about the structure and functioning of the nervous system, as well as its metabolic processes. The department's therapeutic options include catheter-based procedures for the treatment of acute and chronic pathologies of the vessels of the brain and spinal cord. The department's specialists cooperate closely with neurologists and neurosurgeons. In especially complex clinical cases, the doctors of these medical fields gather for a board to develop the most effective, but at the same time sparing treatment regimen. The department is certified in accordance with the requirements of the German Society of Neuroradiology (DGNR), so patients can count on top-class medical care with the use of the very latest medical advances.

Breast cancer is the most common malignant tumor in women. It accounts for every sixth death from cancer. Most countries implement breast cancer screening, so the tumor is increasingly detected at the early stage. Nevertheless, the disease is diagnosed too late in some women, when a radical surgery is impossible. In this case, embolization may become the main treatment method. It is used to combat not only the primary breast tumor, but also to suppress metastases.

Content

  1. What is embolization
  2. When is embolization used
  3. Internal mammary artery embolization
  4. Redistributive embolization
  5. Hepatic artery embolization
  6. Why is it worth undergoing treatment abroad
  7. Treatment in Europe with Booking Health at an affordable price

What is embolization

 

Embolization is a treatment option for breast cancer, which involves closing the lumen of the vessels supplying the tumor. Cancer cells do not receive oxygen, so they die. The technique does not completely eliminate the tumor, but reduces its size, which leads to an increase in life expectancy, alleviation of symptoms, and an increase in the effectiveness of other treatment methods.

As a rule, breast cancer patients do not receive pure embolization, but transarterial chemoembolization (TACE). The technique additionally includes regional chemotherapy. Drugs are delivered directly to the tumor with arterial blood.

To close the lumen of the vessels, doctors use an embolization agent containing chemotherapy drugs. Most often, it is a lipiodol solution. In addition, drug-eluting microspheres are used for the treatment of breast cancer with liver metastases, which block arteries and then gradually release chemotherapy drugs.

Chemoembolization for patients with breast cancer provides the following benefits:

  • Minimal invasion – the procedure is performed through the blood vessels, so the doctor only needs to make a small incision in the thigh to insert the catheter.
  • Duration of hospital stay is only 3-4 days.
  • With the proper performance of the procedure, complications are extremely rare.
  • No need for rehabilitation.
  • Method is combined with other cancer treatments, including radiation and drug therapy.

Chemoembolization reduces the tumor size or stabilizes it. In case of progression, the procedure can be repeated.

When is embolization used

 

TACE is not the main option for the treatment of patients with breast cancer. Surgery is always preferred. Chemotherapy, targeted, hormonal, and radiation therapy can be used additionally.

Embolization of the breast vessels is used for unresectable cancer. The procedure is most often used for edematous-infiltrative type of breast cancer. This is an unfavorable type of pathology, which is observed in 3-4% of women.

Types of this form:

  • Primary edematous or inflammatory cancer – inflammatory breast cancer (IBC). It accounts for 75% of cases. Pathology is manifested by inflammation, redness, soreness, and swelling of the breast.
  • Secondary edematous breast cancer – 25% of cases. Initially, the tumor develops as a nodular cancer, but it is complicated by lymphogenous metastases, due to which the lymph outflow is blocked. The result is breast swelling.

TACE can be used in other unresectable cancers if the patient does not respond to systemic chemotherapy. When using regional chemotherapy, more drugs enter the breast tissue. In addition, the systemic toxicity of the treatment is reduced.

About 80% of patients have liver metastases at the advanced stage of breast cancer. To suppress them, hepatic artery embolization is performed.

Internal mammary artery embolization

 

Chemoembolization of the internal thoracic artery is used in the absence of the possibility of surgical treatment, when systemic chemotherapy does not work.

The treatment procedure is minimally invasive. The doctor makes an incision in the groin to access the femoral artery. He inserts the catheter and reaches the right or left internal thoracic artery. Then an angiography is performed: the doctor uses a contrast agent to imagine the vasculature. When the contrast is injected, a series of X-rays are taken.

TACE is usually performed with lipiodol and chemotherapy (oily chemoembolization). This treatment option does not permanently close the vessels. After a while, the patency of the arteries will be restored. However, while they are closed, there is a rapid death of the tumor, since it has no blood supply.

Although TACE does not permanently cure cancer, breast cancer patients can live for many years after this procedure. Embolization is used in combination with other methods: irradiation, drug therapy. TACE can be performed repeatedly, if necessary. The procedure can be done many times. It is usually performed at 4–6-month intervals. Embolization is used until patients respond to the treatment.

Redistributive embolization

 

During chemoembolization for pancreatic cancer, the embolization agent may enter non-target vessels. This leads to complications: skin necrosis, dysfunction of the internal organs, neuralgia (pain along the nerves).

To avoid complications, European specialists carry out redistributive chemoembolization in the internal thoracic artery basin. Doctors introduce microcoils with a diameter of 2 to 4 mm and a length of 1-2 cm into the vessels. They are implanted beyond the origin of the anterior intercostal branches.

Chemoembolization of the internal mammary artery is performed when the non-target vessels are protected. Such an approach not only reduces the risk of complications, but also improves the therapeutic effect. Due to the closure of the branches, a compensatory expansion of the internal thoracic artery occurs. As a result, blood flow in the breast increases, so more embolization agents penetrate the tumor.

Hepatic artery embolization

 

At the advanced stage of breast cancer with liver metastases, hepatic artery chemoembolization is used. This is not the main treatment option. If possible, liver resection is preferred. However, this treatment method is applicable only to 15% of patients. In addition, the risk of recurrence within 3 years after surgery is 70%, within 5 years – 90%. Liver resection can be repeated in only one out of three patients.

Thus, the operation in most cases is not performed, and therefore the most common method of dealing with metastases is hepatic artery embolization.

The essence of the procedure is similar. The only difference is that emboli are injected into the hepatic artery and not into the internal thoracic artery.

The liver has a dual blood supply. The healthy parenchyma receives 75% of its blood from the portal vein, and only 25% from the hepatic artery. However, the tumor is supplied with arterial blood by 90%, therefore, if the arterial blood flow is impaired, it quickly dies off. Damage to healthy tissues is minimal, since they continue to receive blood from the portal vein.

Drug-eluting microspheres are used for hepatic artery TACE in Europe. Unlike oily chemoembolization, they permanently close the vascular lumen. Microspheres do not penetrate as deeply into the liver as they get stuck in small arteries. The advantage of the method is that chemotherapy drugs are released from microspheres gradually, so they can act on the tumor for several weeks. Tests show the advantages of microspheres over oily chemoembolization: they provide a higher response rate with less systemic toxicity of chemotherapy.

Why is it worth undergoing treatment abroad

 

If the level of medicine in your country is low, it is better to undergo treatment of cancer abroad. Embolization of the tumor vessels has been successfully used for decades in the developed European countries. The procedure is carried out successfully and without serious complications.

There are several reasons why you should undergo endovascular embolization for breast cancer abroad:

  • Vast and successful experience in performing chemoembolization for unresectable breast cancer.
  • Modern types of the procedure are used, including the use of drug-eluting microspheres.
  • High-precision diagnostics allows the doctors to assess the blood supply to the tumor in order to make the procedure as effective as possible and to avoid complications.
  • During the procedure, doctors close the non-target vessels with coils to prevent penetration of embolization agents into them.
  • Embolization is used not only to suppress the primary tumor, but also to deal with cancer metastases, which most often develop in the liver.
  • The successful combination of chemoembolization with other treatment methods can increase the life expectancy of patients by 5-10 years, even if the advanced stage cancer is diagnosed.

Treatment in Europe with Booking Health at an affordable price

 

To undergo treatment in one of the European hospitals, please use the services of Booking Health. On our website, you can see the cost of treatment in different hospitals, compare prices and book a medical care program at an affordable price. Transcatheter chemoembolization for breast cancer in European hospitals will be easier and faster for you, and the cost of treatment will be lower.

Please leave your request on our website. Our employee will contact you and provide consultation about treatment in Europe. Booking Health will take care of the organization of your trip. We will provide the following benefits for you:

  • We will select a hospital for treatment in Europe, whose doctors specialize in transcatheter chemoembolization.
  • We will help you overcome the language barrier, establish communication with your attending physician.
  • We will reduce the waiting period for the medical care program and book a doctor's appointment on the most suitable dates.
  • We will reduce the price. The cost of treatment in European hospitals will be decreased due to the lack of coefficients for foreign patients.
  • We will take care of all organizational issues: documents for entering the country, transfer from the airport, hotel, interpreting services, etc.
  • We will prepare a medical care program and translate medical records. You do not have to undergo previously performed diagnostic procedures.
  • We will provide communication with the hospital after treatment in Europe.
  • We will organize additional diagnostic examinations and treatment in European hospitals, if necessary.
  • We will buy medicines abroad and forward them to your native country.
  • We will help you keep in touch with the hospital and the doctor after treatment in Europe.

You will be treated by the best doctors in the world. The Booking Health specialists will help you reduce the cost of treatment and take care of all organizational issues, and you will only have to focus on restoring your health.

Authors: Dr. Nadezhda Ivanisova, Dr. Sergey Pashchenko




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