title: Minimally-invasive treatment of early stage breast cancer: a feasibility study using radiofrequency ablation under local anesthesia.
abstract: The objective of this study was to assess efficacy and safety of percutaneous ultrasound (US) guided preferential radiofrequency ablation (PRFA) in early breast carcinoma under local anesthesia and to evaluate a new assessment protocol. Eighteen breast cancer patients were enrolled in order to receive PRFA treatment three weeks prior to resection. Pain assessment was performed using the visual analoge scale. Analysis of treatment success was performed using magnetic resonance imaging (MRI) as well as histological assays for hematoxylin & eosin (H&E) and cytokeratine 8 (CK8). In a subset of patients contrast enhanced ultrasound (CEUS) was performed before and after treatment. MRI showed no residual tumor growth in 100% (18/18) of cases. Complete tumor devitalization was indicated in 83% (15/18) of patients as judged by H&E staining and in 89% (16/18) as judged by immunostaining for CK8. In 100% (18/18) at least one histologic method showed devitalization in the entire tumor. Treatment was well tolerated. Pain experienced during the procedure was mild. US-guided PRFA of small breast carcinoma is feasible under local anesthesia. MRI and CK8 have proven valuable additions to the RF breast tumor ablation protocol. CEUS shows potential as a modality for radiological follow-up.
authors.affiliation: Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Solna (L1:00), 17176 Stockholm, Sweden. Electronic address: kai-uwe.schassburger@ki.se.
authors.forename: Kai-Uwe
authors.initials: KU
authors.lastname: Schässburger
authors.affiliation: Department of Surgery, Capio S:t Görans Hospital, 11281 Stockholm, Sweden.
authors.forename: Lars
authors.initials: L
authors.lastname: Löfgren
authors.affiliation: Department of Pathology, Unilabs AB, Capio S:t Görans Hospital, 11281 Stockholm, Sweden.
authors.forename: Ulla
authors.initials: U
authors.lastname: Lagerstedt
authors.affiliation: Department of Mammography, Unilabs AB, Capio S:t Görans Hospital, 11281 Stockholm, Sweden.
authors.forename: Karin
authors.initials: K
authors.lastname: Leifland
authors.affiliation: Department of Mammography, Unilabs AB, Capio S:t Görans Hospital, 11281 Stockholm, Sweden.
authors.forename: Karin
authors.initials: K
authors.lastname: Thorneman
authors.affiliation: Department of Pathology, Karolinska Universitetslaboratoriet, Karolinska Institutet Danderyds Sjukhus, 18288 Stockholm, Sweden.
authors.forename: Bengt
authors.initials: B
authors.lastname: Sandstedt
authors.affiliation: Department of Oncology-Pathology, Karolinska Institutet, Karolinska University Hospital, (Z5:02), 17176 Stockholm, Sweden.
authors.forename: Gert
authors.initials: G
authors.lastname: Auer
authors.affiliation: Department of Molecular Medicine and Surgery, Karolinska Institutet, P.O. Box: 39011, 10054 Stockholm, Sweden.
authors.forename: Hans
authors.initials: H
authors.lastname: Wiksell
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local; D001943:Breast Neoplasms / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D010147:Pain Measurement; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods*
keywords: Breast cancer; Minimally invasive; Radiofrequency ablation; Small breast carcinoma