M Noguchi1, A Motoyoshi, M Earashi, H Fujii. 1. Department of Breast and Endocrine Surgery, Kanazawa Medical University Hospital, Uchinada-daigaku, Ishikawa, Japan. nogumasa@kanazawa-med.ac.jp
Abstract
BACKGROUND: Radiofrequency ablation (RFA) is considered to be the most promising non-surgical ablation technique for the treatment of small breast cancer. However, few data are available regarding long-term follow-up of patients treated with this modality. METHODS: Since 2005, we have performed RFA and sentinel lymph node (SLN) biopsy in 19 cases. Axillary lymph node dissection (ALND) was performed in patients with positive SLNs. From 24 to 202 days after RFA, the ablated tumour tissue was excised by mammotome biopsy and examined histologically or immunohistochemically with H&E staining, nicotinamide adenine dinucleotide (NADH)-diaphorase staining, and single-stranded (ss) DNA staining. All cases were followed-up after breast radiation and systemic therapies. RESULTS: Although complete response was histologically confirmed in only 8 cases, NADH-diaphorase and ssDNA staining did not demonstrate any viable tumour cells in the ablated lesions. At a mean follow-up of 60 months (follow-up range, 37-82 months), there were no cases of in-breast recurrence, although one patient died due to hepatic metastases. Cosmesis of the conserved breast was excellent or good in all of the cases, but a hard lump was persistent after RFA in half of the cases. CONCLUSIONS: The long-term outcome of patients treated with RFA is encouraging with regard to cosmesis and local control. Because a persisted lump may cause patient discomfort, anxiety and fear, however, further studies are needed to establish the optimal technique. Moreover, a prospective study will be required to determine the equivalency in local recurrence rates between the RFA therapy and conventional breast-conserving treatment.
BACKGROUND: Radiofrequency ablation (RFA) is considered to be the most promising non-surgical ablation technique for the treatment of small breast cancer. However, few data are available regarding long-term follow-up of patients treated with this modality. METHODS: Since 2005, we have performed RFA and sentinel lymph node (SLN) biopsy in 19 cases. Axillary lymph node dissection (ALND) was performed in patients with positive SLNs. From 24 to 202 days after RFA, the ablated tumour tissue was excised by mammotome biopsy and examined histologically or immunohistochemically with H&E staining, nicotinamide adenine dinucleotide (NADH)-diaphorase staining, and single-stranded (ss) DNA staining. All cases were followed-up after breast radiation and systemic therapies. RESULTS: Although complete response was histologically confirmed in only 8 cases, NADH-diaphorase and ssDNA staining did not demonstrate any viable tumour cells in the ablated lesions. At a mean follow-up of 60 months (follow-up range, 37-82 months), there were no cases of in-breast recurrence, although one patient died due to hepatic metastases. Cosmesis of the conserved breast was excellent or good in all of the cases, but a hard lump was persistent after RFA in half of the cases. CONCLUSIONS: The long-term outcome of patients treated with RFA is encouraging with regard to cosmesis and local control. Because a persisted lump may cause patient discomfort, anxiety and fear, however, further studies are needed to establish the optimal technique. Moreover, a prospective study will be required to determine the equivalency in local recurrence rates between the RFA therapy and conventional breast-conserving treatment.