Toshikazu Ito1, Shoji Oura2, Shinji Nagamine3, Masato Takahashi4, Naohito Yamamoto5, Noboru Yamamichi6, Mitsuharu Earashi7, Hiroyoshi Doihara8, Shigeru Imoto9, Shoshu Mitsuyama10, Kohei Akazawa11. 1. Department of Surgery, Rinku General Medical Center, Izumisano, Osaka, Japan. Electronic address: t-ito@rgmc.izumisano.osaka.jp. 2. Department of Surgery, Wakayama Medical University Hospital, Wakayama, Japan. 3. Department of Surgery, Okinawa Red Cross Hospital, Naha, Japan. 4. Department of Surgery, Hokkaido Cancer Center, Shiroishi-ku, Sapporo, Japan. 5. Division of Breast Surgery, Chiba Cancer Center, Chuo-ku, Chiba, Japan. 6. Fukui Health Service Association, Fukui, Japan. 7. Department of Surgery, Yatsuo General Hospital, Fukujima, Toyama, Japan. 8. Thoracic Surgery and Breast and Endocrinological Surgery, Okayama Graduate School of Medicine, Kita-ku, Okayama, Japan. 9. Department of Breast Surgery, School of Medicine, Kyorin University, Mitaka, Tokyo, Japan. 10. Kitakyushu Municipal Medical Center, Kokurakita-ku, Kitakyushu, Japan. 11. Department of Medical Informatics, Niigata University, Chuo-ku, Niigata, Japan.
Abstract
PURPOSE: To validate the safety and efficacy of percutaneous radiofrequency ablation (RFA) of breast carcinomas. METHODS: This retrospective study was conducted by the Breast Cancer Society for Minimally Invasive Therapy following approval from institutional review boards, and with the written informed consent of patients. A total of 386 patients with breast cancer treated with RFA at 10 institutions between July 2003 and June 2009 were identified and included in the analysis. Patients underwent a standard RFA procedure with ultrasound guidance and were followed up every 6 to 12 months. In this study, feasibility of RFA procedure and related safety and ipsilateral breast tumor recurrence (IBTR) were examined. Fisher exact or χ2 test evaluated associations between clinicopathological factors and IBTR, and local recurrence-free survival was estimated using the Kaplan-Meier method. RESULTS: RFA-related adverse events included local pain in 9 patients, skin burns in 15, and nipple retraction in 7. Patients were followed for a median of 50 months. IBTR was more frequently observed in patients with initial tumor sizes > 2 cm (3 of 30, 10%) than in those with initial tumors ≤ 2 cm (8 of 355, 2.3%; P = .015). IBTR-free rates 5 years after RFA were 97%, 94%, and 87% in patients with initial tumor sizes ≤ 1.0 cm, 1.1 to 2.0 cm, and > 2.0 cm, respectively. CONCLUSIONS: RFA in breast cancer is a safe and promising minimally invasive treatment for tumors ≤ 2 cm in diameter. Further studies are needed to optimize the technique and evaluate its future role as local therapy.
PURPOSE: To validate the safety and efficacy of percutaneous radiofrequency ablation (RFA) of breast carcinomas. METHODS: This retrospective study was conducted by the Breast Cancer Society for Minimally Invasive Therapy following approval from institutional review boards, and with the written informed consent of patients. A total of 386 patients with breast cancer treated with RFA at 10 institutions between July 2003 and June 2009 were identified and included in the analysis. Patients underwent a standard RFA procedure with ultrasound guidance and were followed up every 6 to 12 months. In this study, feasibility of RFA procedure and related safety and ipsilateral breast tumor recurrence (IBTR) were examined. Fisher exact or χ2 test evaluated associations between clinicopathological factors and IBTR, and local recurrence-free survival was estimated using the Kaplan-Meier method. RESULTS: RFA-related adverse events included local pain in 9 patients, skin burns in 15, and nipple retraction in 7. Patients were followed for a median of 50 months. IBTR was more frequently observed in patients with initial tumor sizes > 2 cm (3 of 30, 10%) than in those with initial tumors ≤ 2 cm (8 of 355, 2.3%; P = .015). IBTR-free rates 5 years after RFA were 97%, 94%, and 87% in patients with initial tumor sizes ≤ 1.0 cm, 1.1 to 2.0 cm, and > 2.0 cm, respectively. CONCLUSIONS: RFA in breast cancer is a safe and promising minimally invasive treatment for tumors ≤ 2 cm in diameter. Further studies are needed to optimize the technique and evaluate its future role as local therapy.