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Radiofrequency Ablation of Invasive Breast Carcinomas: A Phase II Trial

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Local ablative therapy of breast cancer represents the next frontier in the minimally invasive breast-conservation treatment. We conducted a phase II trial to evaluate radiofrequency ablation (RFA) of invasive breast carcinomas.

Methods

Consecutive patients from two Mexican Institutions with invasive breast cancers < 4 cm, with no multicentric tumors and no previous chemotherapy were included in this trial. Under ultrasound guidance, the tumor and a 5 mm margin of surrounding breast tissue were ablated with saline-cooled RFA electrode followed by surgical resection. Routine pathologic analysis and viability evaluation with NADPH-diaphorase stain were performed to assess tumor ablation. Procedure-associated morbidity was recorded.

Results

Twenty-five patients were included. Mean patient age was 55.3 years (range 42–89 years). Mean tumor size was 2.08 cm (range 0.9–3.8 cm). Fourteen tumors (56%) were <2 cm. The mean ablation time was 11 minutes using a mean power of 35 W. During ablation, the tumors become progressively echogenic that corresponded with the region of severe RFA injury at pathologic examination. Of the 25 patients treated, NADPH stain showed no evidence of viable malignant cells in 19 patients (76%), with significant difference between tumors <2 cm (complete necrosis in 13 of 14 cases, 92.8%) vs. those >2 cm (complete necrosis 6 of 11 cases, 54.5%) (P < .05). No significant morbidity was recorded.

Conclusions

RFA is a promising minimally invasive treatment of small breast carcinomas, as it can achieve effective cell killing with a low complication rate. Further studies are necessary to optimize the technique and evaluate its future role as local therapy for breast cancer.

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References

  1. Fisher B. From Halsted to prevention and beyond: advances in the management of breast cancer during the twentieth century. Eur J Cancer 1999; 35:1963–73

    Article  PubMed  CAS  Google Scholar 

  2. Giuliano AE, Jones RC, Brennan M, et al. Sentinel lymphadenectomy in breast cancer. J Clin Oncol 1997; 15:2345–50

    PubMed  CAS  Google Scholar 

  3. Vrieling C, Collete L, Fourquet A, et al. The influence of patient, tumor and treatment factors on the cosmetic results after breast-conserving therapy in EORTC “boost vs. no boost” trial. EORTC Radiotherapy and Breast Cancer Cooperative Groups. Radiother Oncol 2000; 55:219–32

    Article  PubMed  CAS  Google Scholar 

  4. Singletary SE. Minimally invasive techniques in breast cancer treatment. Semin Oncol 2001; 20:246–50

    Article  CAS  Google Scholar 

  5. Kopelman D, Papa M. Magnetic-resonance-guided focused ultrasound surgery for the non-invasive curative ablation of tumors and palliative treatments: a review. Ann Surg Oncol 2007; 14:1540–50

    Article  PubMed  Google Scholar 

  6. Summer WE, Koniaris LG, Snell SE, et al. Results of 23,810 cases of ductal carcinoma in situ. Ann Surg Oncol 2007; 14:1638–43

    Article  Google Scholar 

  7. McGrahan JP, Griffey SM, Schneider PD, et al. Radiofrequency electrocautery ablation of mammary tissue in swine. Radiology 2000; 217:471–6

    Google Scholar 

  8. Vergara-Fernandez O, Cortes-Gonzalez R, Medina-Franco H. Sentinel node validation in breast cancer with two different techniques. Rev Invest Clin 2004; 56:309–13

    PubMed  Google Scholar 

  9. Monroe M, Strom EA, Basset LW, et al. Standard for breast conservation therapy in the management of invasive breast carcinoma. CA Cancer J Clin 2002; 52:277–300

    Article  Google Scholar 

  10. Khatri VP, McGahan JP, Ramsamooj R, et al. A phase II trial of image-guided radiofrequency ablation of small invasive breast carcinomas: use of saline-cooled tip electrode. Ann Surg Oncol 2007; 14:1644–52

    Article  PubMed  Google Scholar 

  11. Park JK, Halperin BD, Kron J, et al. Analysis of body surface area as determinant of impedance during radiofrequency catheter ablation in adults and children. J Electrocardiol 1994; 27:329–32

    Article  PubMed  CAS  Google Scholar 

  12. Wang D, Hulse JE, Walsh EP, et al. Factors influencing impedance during radiofrequency ablation in humans. Chin Med J (Engl) 1995; 108:450–5

    CAS  Google Scholar 

  13. Jeffrey SS, Birdwell RR, Ikeda DM, et al. Radiofrequency ablation of breast cancer: first report of an emerging technology. Arch Surg 1999; 134:1064–8

    Article  PubMed  CAS  Google Scholar 

  14. Izzo F, Thomas R, Delrio P, et al. Radiofrequency ablation in patients with primary breast carcinoma: a pilot study in 26 patients. Cancer 2001; 92:2036–44

    Article  PubMed  CAS  Google Scholar 

  15. Fornage BD, Sneige N, Ross MI, et al. Small (< or = 2 cm) breast cancer treated with US-guided radiofrequency ablation: feasibility study. Radiology 2004; 231:215–24

    Article  PubMed  Google Scholar 

  16. Hayashi AH, Silver SF, van der Westhuizen NG, et al. Treatment of invasive breast carcinoma with ultrasound-guided radiofrequency ablation. Am J Surg 2003; 185:429–35

    Article  PubMed  Google Scholar 

  17. Wood BG, Ramkaransingh JR, Fojo F, et al. Percutaneous tumor ablation with radiofrequency. Cancer 2002; 94:443–51

    Article  PubMed  Google Scholar 

  18. Marcy PY, Magné N, Castadot P, et al. Ultrasound-guided percutaneous radiofrequency ablation in elderly breast cancer patients: preliminary institutional experience. Br J Radiol 2007; 80:267–73

    Article  PubMed  Google Scholar 

  19. Oura S, Tamaki T, Hirai I, et al. Radiofrequency ablation therapy in patients with breast cancers two centimeters or less in size. Breast Cancer 2007; 14:48–54

    Article  PubMed  Google Scholar 

  20. Burak WE Jr, Agnese DM, Povoski SP, et al. Radiofrequency ablation of invasive breast carcinoma followed by delayed surgical excision. Cancer 2003; 98:1369–76

    Article  PubMed  Google Scholar 

  21. Dowlatshahi K, Fan M, Gould VE. Stereotactically guided laser therapy of occult breast tumors. Arch Surg 2000; 135: 1345–52

    Article  PubMed  CAS  Google Scholar 

  22. Sabel MS, Kaufman CS, Whitworth P, et al. Cryoablation of early-stage breast cancer: work-in progress report of a multi-institutional trial. Ann Surg Oncol 2004; 11:542–9

    Article  PubMed  Google Scholar 

  23. Raman SS, Lu DS, Vodopich DJ, et al. Creation of radiofrequency lesions in a porcine model: correlation with sonography, CT, and histopathology. Am J Roentgenol 2000; 175:1253–8

    CAS  Google Scholar 

  24. Brookes JA, Redpath TW, Gilbert FJ, et al. Accuracy of T1 measurement in dynamic contrast-enhanced breast MRI using two- and three- dimensional variable flip angle fast low-angle shot. J Magn Reson Imaging 1999; 9:163–71

    Article  PubMed  CAS  Google Scholar 

  25. Tafra L, Cheng Z, Uddo J, et al. Pilot clinical trial of 18F-florodeoxyglucose positron-emission mammography in the surgical management of breast cancer. Am J Surg 2005; 190:628–32

    Article  PubMed  Google Scholar 

  26. Jan ML, Chuang KS, Chen GW, et al. A three-dimensional registration method for automated fusion of micro PET-CT-SPECT whole body images. Trans Med Imaging 2005; 24:886–93

    Article  Google Scholar 

  27. Singletary SE. Surgical margins in patients with early-stage breast cancer treated with breast conservation therapy. Am J Surg 2002; 184:383–93

    Article  PubMed  Google Scholar 

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Acknowledgment

This study was supported by grant of Medical Dimegar, Mexico. The authors want to thank Dr. Jorge Zerón-Medina Cuairán for his editorial assistance.

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Authors and Affiliations

  1. Department of Surgery, Section of Surgical Oncology, National Institute of Medical Sciences and Nutrition “Salvador Zubirán”, Vasco de Quiroga 15, Colonia Seccion XVI, Tlalpan, Mexico City, Mexico

    Heriberto Medina-Franco MD & Santos Soto-Germes MD

  2. Department of Radiology, Section of Breast Imaging, National Institute of Medical Sciences and Nutrition “Salvador Zubirán”, Mexico City, Mexico

    José L. Ulloa-Gómez MD & Cecilia Romero-Trejo MD

  3. Department of Pathology, National Institute of Medical Sciences and Nutrition “Salvador Zubirán”, Mexico City, Mexico

    Norma Uribe MD

  4. Department of Surgery, Section of Surgical Oncology, Hospital Angeles Leon, Leon, Mexico

    Carlos A. Ramirez-Alvarado

  5. Department of Surgery, Section of Surgical Oncology, National Cancer Institute, Mexico City, Mexico

    Carlos Robles-Vidal

Authors
  1. Heriberto Medina-Franco MD
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  2. Santos Soto-Germes MD
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  3. José L. Ulloa-Gómez MD
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  4. Cecilia Romero-Trejo MD
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  5. Norma Uribe MD
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  6. Carlos A. Ramirez-Alvarado
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  7. Carlos Robles-Vidal
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Corresponding author

Correspondence to Heriberto Medina-Franco MD.

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Medina-Franco, H., Soto-Germes, S., Ulloa-Gómez, J.L. et al. Radiofrequency Ablation of Invasive Breast Carcinomas: A Phase II Trial. Ann Surg Oncol 15, 1689–1695 (2008). https://doi.org/10.1245/s10434-008-9875-4

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  • DOI: https://doi.org/10.1245/s10434-008-9875-4

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