Radiofrequency ablation of breast cancer: a comparative study of two needle designs.
BACKGROUND
Radiofrequency ablation (RFA) is an emerging minimally invasive technique for breast cancer treatment. There are two different needle designs. One is to deploy a series of arrays to allow an even distribution of heat within the tumor. A new design is a straight needle with continuous infusion of cold saline to prevent charring and ensure continuous heat delivery. We report the first comparative study using two different needles for ablation of breast cancer.


METHODS
Chinese patients with breast cancer less than 2 cm were prospectively recruited. Multifocal tumor was excluded. RFA was performed under general anesthesia following sentinel node biopsy. Sequential allocation was used. In the first group, tumor was ablated by using the LeVeen needle. Cool-tip needle was used in the subsequent group. The tumor was then resected. Tumor viability was assessed by nicotinamide adenine dinucleotide-diaphorase (NADH) staining. Complete ablation rate was compared. Evidence of thermal damage to the skin was also assessed.


RESULTS
Twenty patients were recruited. Mean tumor size was 14 mm. Complete ablation rate was the same (90% versus 89% for the Cool-tip and the LeVeen, respectively). Cool-tip has a shorter ablation time when compared with LeVeen (12 versus 28 min), and the Cool-tip needle was found to be easier to insert. There was no visible skin burn after RFA.


CONCLUSIONS
Cool-tip and LeVeen systems had the same efficacy in ablation of breast cancer, but Cool-tip was easier to insert and had a shorter ablation time.
Hung
Wai Ka
WK
Department of Surgery, Breast Centre, Kwong Wah Hospital, 25 Waterloo Road, Kowloon, Hong Kong. hwkhwk@netvigator.com
Mak
Kong Ling
KL
Ying
Marcus
M
Chan
Miranda
M
D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006801:Humans; D008875:Middle Aged; D009339:Needles; D011960:Receptors, Estrogen / Q000032:analysis
D011960:Receptors, Estrogen