Ultrasound-guided Percutaneous Radiofrequency-assisted Breast Excision to Remove En-bloc Specimens: Five Years' Experience

Abstract

Objectives: To describe our initial 5-year experience in using the radiofrequency-assisted excision technology in a regional hospital, with an emphasis on the efficacy, techniques, and safety of the procedure. Methods: Clinical records and operative data of all patients who underwent ultrasound-guided radiofrequencyassisted excision of breast lesions between September 2008 and May 2013 in Kwong Wah Hospital, Hong Kong, were retrospectively reviewed. Results: A total of 48 consecutive patients and 50 lesions with a mean diameter of 9.2 mm were included. Of the 50 lesions, 27 (54%) were graded Breast Imaging-Reporting and Data System (BI-RADS) 3, 21 (42%) BI-RADS 4, and 2 (4%) BI-RADS 5. The mean operating duration was 6.3 minutes. Final pathology showed 1 ductal carcinoma in-situ, 20 fibroadenomata, 11 fibrocystic changes, 9 papillomata, and 11 miscellaneous benign entities. Complete removal with histological clear margins was achieved in 82% of the lesions. No histological underestimation or recurrence was found on subsequent open surgery or follow-up. The procedure was welltolerated, with a mean pain score of 1.35 out of 5. One patient (2%) experienced a complication of haematoma formation requiring surgical treatment. Conclusion: Ultrasound-guided percutaneous radiofrequency-assisted breast excision is a robust diagnostic tool and therapeutic procedure that allows safe, quick, and efficacious en-bloc lesion removal with clear margins. This minimally invasive office procedure is a promising alternative to conventional open excision of benign breast lesions.