Radiofrequency ablation as local therapy for early breast carcinomas.
OBJECTIVE
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.


METHODS
Fifty patients with core-needle biopsy-proven breast carcinoma that was ≤ 3 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 ≤ 2 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.


CONCLUSIONS
RF ablation is a safe and promising minimally invasive treatment for small breast carcinomas with pathological tumor size ≤ 2 cm in diameter and without EIC.
Kinoshita
Takayuki
T
Surgical Oncology Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan. takinosh@ncc.go.jp
Iwamoto
Eriko
E
Tsuda
Hitoshi
H
Seki
Kunihiko
K
D002288:Adenocarcinoma, Mucinous / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000473:pathology / Q000601:surgery*; D018275:Carcinoma, Lobular / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation; D008058:Dihydrolipoamide Dehydrogenase / Q000097:blood; D005260:Female; D006801:Humans; D008875:Middle Aged; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult
D008058:Dihydrolipoamide Dehydrogenase