Minimally-invasive treatment of early stage breast cancer: A feasibility study using radiofrequency ablation under local anesthesia

• Published in: Breast (Edinburgh) Vol. 23; no. 2; pp. 152 - 158
• Main Authors: Schässburger, Kai-Uwe, Löfgren, Lars, Lagerstedt, Ulla, Leifland, Karin, Thorneman, Karin, Sandstedt, Bengt, Auer, Gert, Wiksell, Hans
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.04.2014
• Subjects: Aged; Aged, 80 and over; Anesthesia, Local; Breast cancer; Breast Neoplasms - surgery; Catheter Ablation - methods; Feasibility Studies; Female; Hematology, Oncology and Palliative Medicine; Humans; Medicin och hälsovetenskap; Middle Aged; Minimally invasive; Minimally Invasive Surgical Procedures - methods; Pain Measurement; Radiofrequency ablation; Small breast carcinoma; Treatment Outcome; Ultrasonography, Interventional - methods; Radiofrequency ablation; Breast cancer; Small breast carcinoma; Minimally invasive
• ISSN: 0960-9776; 1532-3080; 1532-3080
• DOI: 10.1016/j.breast.2013.12.007

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.