Minimally Invasive Treatment of Breast Cancer (original) (raw)
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Treatment of invasive breast carcinoma with ultrasound-guided radiofrequency ablation
The American Journal of Surgery, 2003
Radiofrequency ablation (RFA) is a minimally invasive thermal ablation technique. This study reports the safety and efficacy of RFA as a minimally invasive strategy for breast cancers <3 cm diameter in postmenopausal women. Twenty-two postmenopausal women (aged 60 years or older) with clinical T-1N0 core biopsy proven breast cancers were studied. Thermocoagulation was undertaken using a sonographically guided RF probe under local anesthesia and sedation. The ablated tumor was resected between 1 and 2 weeks later. Endpoints were technical success, completeness of tumor kill, marginal clearance, skin damage, and patient reports of pain and procedural acceptability. The procedure was well tolerated and cosmesis was excellent. Pathology revealed a central ablation zone surrounded by hyperemia. Coagulative necrosis was complete in 19 of 22 patients. Disease at the ablation zone margin was found in 3 patients and 5 patients had disease distant to the ablation zone consisting of multifocal tumors (2), in-transit metastasis (1), and extensive ductal carcinoma in situ with microinvasive carcinoma (2). Ninety-five percent of patients would be willing to have RFA again. Radiofrequency ablation can be safely applied in an outpatient setting with acceptable patient tolerance. By itself, RFA cannot be considered effective local therapy. Trials to evaluate RFA complemented with breast irradiation are justified.
Radiofrequency ablation as local therapy for early breast carcinomas
Breast Cancer, 2011
Purpose To evaluate the safety and efficacy of radiofrequency ablation (RFA) as a local therapy for early breast carcinomas, we performed a phase I/II study at our institution. Patients and methods Fifty patients with core-needle biopsy-proven breast carcinoma that was B3 cm in diameter on ultrasonography were enrolled in this study. Under ultrasound (US) guidance, the tumor and surrounding breast tissue were ablated with a saline-cooled RF electrode followed by immediate surgical resection. Resected specimens were examined by hematoxylin and eosin (H&E) staining and nicotinamide adenine dinucleotide (NADH) diaphorase staining to assess tumor viability. Results Forty-nine patients completed the treatment. The mean tumor size was 1.70 cm. The mean ablation time was 8.7 min using a mean power of 48.5 W. Of the 49 treated patients, complete ablation was recognized in 30 patients (61%) by H&E staining and/or NADH diaphorase staining. The NADH viability staining was available for 38 patients, and in 29 (76.3%), there was no evidence of viable malignant cells. Of the 29 treated patients with breast carcinomas B2 cm in diameter examined by pathological examination, complete ablation was achieved in 24 patients (83%). Of the 26 treated patients with breast carcinomas without an extended intraductal component (EIC) according to pathological examination, complete ablation was determined in 22 patients (85%). RFA-related adverse events were observed in five cases: two with skin burn and three with muscle burns. Conclusion RF ablation is a safe and promising minimally invasive treatment for small breast carcinomas with pathological tumor size B2 cm in diameter and without EIC.
Minimal Invasive Ablative Techniques in the Treatment of Breast Cancer: a Systematic Review
International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group, 2016
Breast conserving surgery is effective for breast cancer treatment but is associated with morbidity in particular high re-excision rates. We performed a systematic review to assess the current evidence for clinical outcomes with minimally invasive ablative techniques in the non-surgical treatment of breast cancer. A systematic search of the literature was performed using PubMed and Medline library databases to identify all studies published between 1994 and May 2016. Studies were considered eligible for inclusion if they evaluated the role of ablative techniques in the treatment of breast cancer and included ten patients or more. Studies that failed to fulfil the inclusion criteria were excluded. We identified 63 studies including 1608 patients whose breast tumours were treated with radiofrequency (RFA), high intensity focused ultrasound (HIFU), cryo-, laser or microwave ablation. Fifty studies reported on the number of patients with complete ablation as found on histopathology and ...
Breast Care, 2013
Cryoablation · Radiofrequenzablation · Mammakarzinom · Perkutane Ablation · MRT · Minimalinvasive Techniken Zusammenfassung Hintergrund: Ziel dieser Studie war es, die Effizienz der Radiofrequenzablation im Vergleich zur Cryoablation zur Behandlung des frühen Mammakarzinoms zu verglei chen. Patientinnen und Methoden: 80 Frauen (mittleres Alter 73 ± 5 Jahre) mit einem primären Mammakarzinom wurden retrospektiv evaluiert. Bei 40 Patientinnen wurde eine Cryoablation und bei weiteren 40 eine Radiofre quenzablation durchgeführt (jeweils mit Sentinelknoten entfernung). Tumorvolumen und histopatologische Daten wurden mittels 3.0TMagnetresonanztomogra phie (MRT) im Anschluss an den Eingriff bestimmt. 30-45 Tage nach der perkutanen Ablation wurde bei allen Patientinnen eine chirurgische Tumorentfernung vorgenommen. Das mittlere Followup war 18 Monate; während dieser Zeit traten keine Lokalrezidive auf. Ergebnisse: Für beide Methoden konnte eine gute Korre lation mit histopathologischen Daten gezeigt werden. Bei 75 (93,8%) Patientinnen wurde eine komplette Nekro tisierung beobachtet; in 5 Fällen zeigten das KontrollMRT und die postoperative histologische Untersuchung Rest tumorgewebe. Es bestand eine gute Korrelation zwi schen MRTVolumen und den histologischen Proben. Das kosmetische Outcome war bis auf 2 Fälle gut. Schlussfolgerung: Die perkutane Radiofrequenzablation und die Cryotherapie sind minimalinvasive Methoden mit einem guten klinischen und kosmetischen Outcome in ausgewählten Fällen. MRT ist eine ideale Methode zur qualitativen und quantitativen Charakterisierung von Mammakarzinomen sowie dem Ausmaß von Resttumor gewebe nach perkutaner Ablation. Cryotherapie wird der RFA vorgezogen, da der analgetische Effekt des Verei sens mit besserer Patientcompliance einhergeht.
Radiofrequency ablation for breast cancer
Techniques in vascular and interventional radiology, 2013
Although breast-conserving therapy or mastectomy remains the gold standard for breast cancer treatment, minimally invasive alternatives to surgery are becoming more attractive for select patient populations. Advances in technology, reduced morbidity, improved cosmesis, and the ability to provide treatment in an outpatient setting are some of the advantages of image-guided therapy. Radiofrequency ablation (RFA) has been investigated because of its relatively low cost, low morbidity, and favorable technical success rates (76%-100% in published series). Image guidance during ablation involves the use of real-time ultrasound or magnetic resonance imaging to target the tumor and monitor the adequacy of ablation. Tumor size, location, histologic type, and reliable visualization under ultrasound (or other imaging modalities) are important to determine patient eligibility and procedural planning. In patients with localized breast cancer who decline surgery or are not candidates for surgery,...
Minimally invasive therapy for the treatment of breast tumours
2002
Minimally invasive therapy has been explored as a potential means of treating breast tumours with minimal disruption to adjacent soft tissues. The purpose of this is to facilitate improved cosmesis and to offer treatment to women who are unfit for surgery. A number of treatment modalities including thermal therapies (intersitital laser photocoagulation, radiofrequency, focused ultrasound and cryotherapy), percutaneous excision and interstitial radiotherapy are being developed. The experience to date of each of these modalities is described and reviewed. Currently there are too few data to indicate the efficacy of these treatments although the preliminary data are encouraging. The need for large-scale studies examining the role of MIT in relationship to the overall management of breast cancer (including chemotherapy, radiotherapy, and the management of the axilla) and outcome is discussed.
The Breast, 2010
The purpose of this study was to determine the safety and efficacy of percutaneous ultrasound (US) guided preferential radiofrequency ablation (PRFA) of unifocal human invasive breast carcinoma with largest radiological diameters of up to 16 mm. Thirty-three patients were enrolled in a study to be treated prior to scheduled partial mastectomy. A needle-shaped treatment electrode, successively developed in two different sizes, was placed into the center of the lesions using ultrasound guidance. A temperature of 85 C was maintained for 10 min. The analysis of the resected specimen was performed using conventional histopathological methods with the aim to determine the size of the lesion as well as the potential viability of tumor cells. Of the 33 patients enrolled 31 were treated. In 26 (84%) patients a complete ablation of the tumor was achieved. Ultrasound guided preferential radiofrequency ablation of small breast carcinoma is feasible and patient friendly. The success rate depends on accurate preoperative diagnostic imaging as well as an exact position of the needle electrode.
Feasibility of Percutaneous Excision Followed by Ablation for Local Control in Breast Cancer
Annals of Surgical Oncology, 2011
Objectives-Percutaneous ablation of breast cancer has shown promise as a treatment alternative to open lumpectomy. We hypothesized that percutaneous removal of breast cancer followed by percutaneous ablation to sterilize and widen the margins would not only provide fresh naïve tissue for tumor marker and research investigation but better achieve negative margins post ablation.