Abstract
ObjectiveThis report describes the first clinical experience with magnetic resonance imaging-guided focused ultrasound surgery (MRgFUS) using the ExAblate 2100 system for non-invasive breast cancer.MethodsTwo women with non-invasive breast cancer underwent MRgFUS treatment. One week after the MRgFUS treatment, US-guided vacuum-assisted biopsy was performed for the ablated lesions at the same time as breast-conserving surgery.ResultsThe patients experienced good cosmetic outcomes and did not experience any severe adverse events, such as skin burns. Pathological examination of the surgical specimens revealed a few degenerated intraductal lesions around the breast biopsy markers.ConclusionPerforming MRgFUS with the new ExAblate 2100 system appears to be safe and feasible. The histopathological results revealed that adequate ultrasound energy in the appropriate location can induce tumor necrosis.
Highlights
Breast cancer treatment has focused on treatment escalation to improve clinical outcomes
Most ductal carcinoma in situ (DCIS) cases involve no palpable lesion, the ablated lesion becomes palpable after magnetic resonance-guided focused ultrasound surgery (MRgFUS) treatment
During the MRgFUS treatment, each sonication was performed for 20 s followed by 1 min of cooling time to avoid skin burning
Summary
Breast cancer treatment has focused on treatment escalation to improve clinical outcomes. Ductal carcinoma in situ (DCIS) has generally mild biological characteristics and treatment de-escalation, such as active surveillance, has recently become more prevalent for managing DCIS [1,2,3,4,5,6] In this scenario, minimally invasive techniques have attracted attention as alternatives to lumpectomy, such as radiofrequency ablation, cryosurgery, and high-intensity focused ultrasound (HIFU) [7]. Minimally invasive techniques have attracted attention as alternatives to lumpectomy, such as radiofrequency ablation, cryosurgery, and high-intensity focused ultrasound (HIFU) [7] Among these techniques, magnetic resonance-guided focused ultrasound surgery (MRgFUS) is MRI-guided HIFU is a truly noninvasive procedure that provides closed-loop therapy with accurate tumor location and real-time thermal monitoring. Additional advantages of MRgFUS include eliminating the need for general anesthesia and hospitalization, avoiding breast
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