Purpose of Review <p>The purpose of this manuscript is to review the current data regarding the 5 types of ablative therapy studied for local control in early-stage breast cancer.</p> Recent Findings <p>With proper patient selection and technique, the local control outcomes with ablative techniques are similar to surgical options. The ablative modalities are best used in tumors with favorable histology, including early stage, luminal A invasive ductal carcinomas with minimal extensive intraductal component. Complete ablation is directly related to the accuracy of probe placement which can be visualized real time with ultrasound. The ablation techniques have additional effects on the tumor microenvironment affecting the immune response and ongoing studies are in progress to assess the use of tumor ablation with immunotherapy.</p> Summary <p>When utilizing one of these ablative techniques, consider limiting ablation to those cancers under 2 cm with favorable histology and visible by US only. All other use of ablation techniques should be in the context of clinical trial protocols.</p>