Breast-conservative surgery followed by radiofrequency ablation of margins decreases the need for a second surgical procedure for close or positive margins.
BACKGROUND
Excision of breast cancer followed by radiofrequency ablation (eRFA) is a technique designed to increase negative margins in breast-conservative surgical procedures. The objective of this study is to analyze the impact of eRFA in avoiding a second surgical procedure for close or positive margins after a breast-conservative surgical procedure.


METHODS
From February 2008 to May 2010, 20 patients were included. After lumpectomy, the eRFA was performed in the lumpectomy cavity, and biopsies from each margin from the radial ablated cavity walls were obtained. Biopsy samples were assessed for tumor viability.


RESULTS
eRFA was successful in 19 of 20 patients. In all patients, the devitalized tissue extended beyond a 5- to 10-mm radial depth of the biopsy sample. Overall, 6 patients (31%) had margins < 2 mm, 4 of them with < 1 mm margin. All 6 of these patients had no tumor viability according to analysis of biopsy samples stained with 2,3,5-triphenyltetrazolium chloride. At a median follow-up of 46 months, no local recurrence had been found.


CONCLUSIONS
This study supports the feasibility of eRFA treatment. In our study, the eRFA method has spared 31% of patients from undergoing a re-excision surgical procedure, and it may, in the long-term, reduce local recurrences.
Breast Surgical Unit, Breast Cancer Center, Vall d'Hebron Instituto de Oncología. Hospital Universitario Vall d'Hebron. Universitat Autònoma de Barcelona, Barcelona, Spain. Electronic address: irubio@vhebron.net.
Isabel T
IT
Rubio
Department of Pathology, Vall d'Hebron Instituto de Oncología. Hospital Universitario Vall d'Hebron. Universitat Autònoma de Barcelona, Barcelona, Spain.
Stefania
S
Landolfi
Department of Radiation Oncology, Vall d'Hebron Instituto de Oncología. Hospital Universitario Vall d'Hebron. Universitat Autònoma de Barcelona, Barcelona, Spain.
Meritxell
M
Molla
Department of Medical Oncology, Breast Cancer Center, Vall d'Hebron Instituto de Oncología. Hospital Universitario Vall d'Hebron. Universitat Autònoma de Barcelona, Barcelona, Spain.
Javier
J
Cortes
Breast Surgical Unit, Breast Cancer Center, Vall d'Hebron Instituto de Oncología. Hospital Universitario Vall d'Hebron. Universitat Autònoma de Barcelona, Barcelona, Spain.
Jordi
J
Xercavins
D000368:Aged; D001943:Breast Neoplasms / Q000628:therapy*; D018270:Carcinoma, Ductal, Breast / Q000628:therapy*; D017115:Catheter Ablation / Q000379:methods*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental / Q000379:methods*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D017060:Patient Satisfaction
Breast cancer; Lumpectomy cavity; Radiofrequency ablation; Recurrences; Reoperation