Feasibility study on radiofrequency ablation followed by partial mastectomy for stage I breast cancer patients.

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Abstract Abstract #4150 Backgrounds: Breast-conserving surgery (BCS) is a standard care for early breast cancer patients. However, local control is not sufficient for surgery alone and breast irradiation and hormonal treatment in hormone-sensitive tumor are recommended to reduce 10% or less of local failure rate. To evaluate the safety and reliability of thermal ablation therapy instead of BCS, we performed radiofrequency ablation (RFA) for clinical stage I breast cancer patients.
 Patients and methods: The subject was T1N0 breast cancer patient with no extensive intraductal components. Under general anesthesia, sentinel node biopsy, and then RFA immediately followed by BCS was performed. Resected specimens were examined at 5 mm intervals by hematoxylin-eosin (HE) staining and several slices of tumor and non tumor lesions in each case were also evaluated by nicotinamide adenine dinucleotide (NADH) diaphorase staining.
 Results: Thirty of the 34 eligible patients were enrolled (88%) about 2 years. Tumor diameters by ultrasound ranged from 9 mm to 24 mm. RFA-relating adverse events were observed in 2 cases of skin burn and 7 of muscle burn in major pectral muscle. There was one case of technical failure due to insufficient electrode replacement into the tumor. Twenty-eight cases (93%) revealed pathological degeneration changes of tumor specimens with HE staining. However, 2 cases had viable tumor cells of intraductal components beyond ablated breast tissues. In 24 of the 26 cases (92%) examined by NADH diphorase staining, tumor viability was diagnosed as negative. Finally, the complete ablation rate was 87% (26/30).
 Conclusions: RFA proved to be reliable and feasible in clinical stage I breast cancer without extensive intraductal components. RFA will be an alternative to BCS as surgical treatment in such a case. Randomized clinical trials to compare RFA with BCS in breast cancer should be required. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 4150.