“Wide local ablation” of localized breast cancer using high intensity focused ultrasound

Abstract

High intensity focused ultrasound (HIFU) is a non-invasive technique for tumor ablation. The goal of this study was to investigate the feasibility of performing wide local ablation using ultrasound-guided HIFU in the treatment of patients with localized breast cancer. Twenty-three patients with histologically proven breast cancer were enrolled in this prospective clinical trial. They underwent HIFU treatment for breast cancer including the tumor and 1.5-2.0 cm normal breast tissue surrounding the tumor, followed by modified mastectomy 1-2 weeks after HIFU. Radiological examination, histological, and terminal deoxynucleotidyl transferase-mediated nick end labeling (TUNEL) methods were performed to evaluate therapeutic effects in the treated region. Thermal ablation was confirmed in all 23 patients. It included tumor and normal breast tissue surrounding the tumor. Mean values of the largest parallel and perpendicular dimensions, and volume of HIFU lesions in excised breasts were significantly larger than those of the targeted tumors respectively (P < 0.001). Hematoxylin and eosin (H & E) staining showed clear evidence of complete coagulation necrosis in the treated regions. However, no apoptotic cells were detected in either treated tumor or normal breast tissue. As a non-invasive therapy, ultrasound-guided HIFU can induce wide local ablation in the treatment of patients with localized breast cancer.