Radiofrequency ablation of invasive breast carcinoma followed by delayed surgical excision

Burak, William E.; Agnese, Doreen M.; Povoski, Stephen P.; Yanssens, L R N Tamara; Bloom, Kenneth J.; Wakely, Paul E.; Spigos, Dimitrios G.

doi:10.1002/cncr.11642

Cited by 181 publications

(141 citation statements)

References 51 publications

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“…Since the first report in 1999, only a few studies have been published on RFA for breast cancer treatment and all focused on US-guided RFA (5,(7)(8)(9)(10)(11)18). The largest study to date is published by Izzo et al (9).…”

Section: Discussionmentioning

confidence: 99%

“…The experience with RFA in patients with breast carcinoma is still in the early stages of development. All previously reported studies assessing the accuracy of RFA of breast tumors used ultrasound (US) to guide the ablation probe (7)(8)(9)(10)(11). In general, these studies concluded that monitoring the ablation process utilizing real-time US was somewhat inaccurate, because the hyperechogenicity of the heated breast tissue and the ultrasonographic shadowing made it difficult to differentiate between ablated tissue and residual tumor (9,10).…”

mentioning

confidence: 99%

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MRI‐guided radiofrequency ablation of breast cancer: Preliminary clinical experience

Bosch

Daniel

Rieke

et al. 2007

Magnetic Resonance Imaging

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This study was designed to demonstrate the feasibility of MRI-guided radiofrequency ablation (RFA) of breast cancer. A total of three women diagnosed with invasive ductal breast cancer were treated with percutaneous MRI-guided RFA, according to a treat and resect protocol, in our hospital. RFA procedures were performed in an open 0.5T Signa-SP imager allowing direct patient access and realtime monitoring of the procedure. In all patients ablation was performed with a 15-gauge insulated MRI-compatible multiple needle probe. MRI thermometry and contrast-enhanced postablation MRI were used to evaluate the ablation process. Patients underwent lumpectomy within a week of the RFA procedure. Histopathology confirmed successful (100%) tumor ablation in one patient, and partial tumor destruction (33% and 50%, respectively) in two patients. Challenges of MRI-guided breast RFA that need to be solved to facilitate progress of the technique toward clinical practice are discussed. TECHNOLOGIC ADVANCES over the last decade have enabled investigations of minimally invasive ablation of primary breast malignancies (1,2). Percutaneous radiofrequency ablation (RFA), which was first reported for treatment of breast tumors in 1999, uses a multiplewire electrode to destroy tumor cells by thermal coagulation and protein denaturation (3-6). The experience with RFA in patients with breast carcinoma is still in the early stages of development. All previously reported studies assessing the accuracy of RFA of breast tumors used ultrasound (US) to guide the ablation probe (7-11). In general, these studies concluded that monitoring the ablation process utilizing real-time US was somewhat inaccurate, because the hyperechogenicity of the heated breast tissue and the ultrasonographic shadowing made it difficult to differentiate between ablated tissue and residual tumor (9,10).MRI may be a more suitable modality for targeted imaging of breast lesions during RFA (11). Of all imaging modalities, MRI has the highest accuracy for determining the size and extent of breast malignancies (12). Furthermore, MRI potentially allows real-time monitoring of the ablation process (13), which in turn has potential to provide intraprocedural assessment of the completeness of ablation, as well as whether any collateral structures are inadvertently heated. As a consequence, with open MRI systems currently commercially available, interest in MRI-guided tumor ablation techniques is growing. To our knowledge, MRI-guided RFA of malignant breast tumors has not been reported in humans. In this feasibility study, we present our initial experience in three patients and discuss the technical challenges of MRI-guided RFA of breast cancer. MATERIALS AND METHODSWe treated three female breast cancer patients (47, 45, and 60 years of age) with MRI-guided RFA in our hospital, according to a treat and resect protocol approved by our institution's human subjects panel. In all patients the tumor was primarily detected on conventional mammography and additional US as a solitary suspi...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

MRI‐guided radiofrequency ablation of breast cancer: Preliminary clinical experience

Bosch

Daniel

Rieke

et al. 2007

Magnetic Resonance Imaging

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“…A total of 63 articles matched the selection criteria. The 63 articles included 16 feasibility studies [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28], 12 phase I studies [29][30][31][32][33][34][35][36][37][38][39][40], nine phase II studies [41][42][43][44][45][46][47][48][49], three comparative studies [50][51][52], one retrospective study [53], and four randomised controlled trials [54][55][56]. In 18 studies the type of study was not reported [8,[57][58][59][60][61][62][63][64]…”

Section: Selected Studiesmentioning

confidence: 99%

Minimally invasive ablative techniques in the treatment of breast cancer: a systematic review and meta-analysis

Peek

Ahmed

Napoli

et al. 2016

International Journal of Hyperthermia

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Purpose: Breast conserving surgery is effective for breast cancer treatment but is associated with morbidity in particular high re-excision rates. We performed a systematic review to assess the current evidence for clinical outcomes with minimally invasive ablative techniques in the non-surgical treatment of breast cancer.Methods: A systematic search of the literature was performed using PubMed and Medline library databases to identify all studies published between 1994 and May 2016. Studies were considered eligible for inclusion if they evaluated the role of ablative techniques in the treatment of breast cancer and included ten patients or more. Studies that failed to fulfil the inclusion criteria were excluded. Results:We identified 63 studies including 1608 patients whose breast tumours were treated with radiofrequency (RFA), high intensity focused ultrasound (HIFU), cryo-, laser or microwave ablation. Fifty studies reported on the number of patients with complete ablation as found on histopathology and the highest rate of complete ablation was achieved with RFA (87.1%, 491/564) and microwave ablation (83.2%, 89/107). Short-term complications were most often reported with microwave ablation (14.6%, 21/144). Recurrence was reported in 24 patients (4.2%, 24/570) and most often with laser ablation (10.7%, 11/103). The shortest treatment times were observed with RFA (15.6±5.6 minutes) and the longest with HIFU (101.5±46.6 minutes).

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“…Burak et al [15] treated tumours with a mean diameter of 12 mm, creating an ablation zone of 26-45 mm and reported one case with surviving malignancy. Viability was assessed using cytokeratin 8 ⁄ 18 stain.…”

Section: Radiofrequency Ablationmentioning

confidence: 99%

High Temperature Hyperthermia in Breast Cancer Treatment

Rubio¹,

Salas²

2013

Hyperthermia

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Radiofrequency ablation of invasive breast carcinoma followed by delayed surgical excision

Cited by 181 publications

References 51 publications

MRI‐guided radiofrequency ablation of breast cancer: Preliminary clinical experience

MRI‐guided radiofrequency ablation of breast cancer: Preliminary clinical experience

Minimally invasive ablative techniques in the treatment of breast cancer: a systematic review and meta-analysis

High Temperature Hyperthermia in Breast Cancer Treatment

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