Annals of Surgical Oncology

, 18:3079 | Cite as

Feasibility of Percutaneous Excision Followed by Ablation for Local Control in Breast Cancer

  • V. Suzanne Klimberg
  • Cristiano Boneti
  • Laura L. Adkins
  • Maureen Smith
  • Eric Siegel
  • Vladimir Zharov
  • Scott Ferguson
  • Ronda Henry-Tillman
  • Brian Badgwell
  • Soheila Korourian
American Society of Breast Surgeons

Abstract

Purpose

Percutaneous ablation of breast cancer has shown promise as a treatment alternative to open lumpectomy. We hypothesized that percutaneous removal of breast cancer followed by percutaneous ablation to sterilize and widen the margins would not only provide fresh naive tissue for tumor marker and research investigation, but also better achieve negative margins after ablation.

Methods

Patients diagnosed by percutaneous biopsy (ultrasound or stereotactic-guided) with breast cancer ≤1.5 cm, >1 cm from the skin, and ≤1 cm residual disease and no multicentric disease by magnetic resonance imaging were accrued to this institutional review board–approved study. Patients were randomized to laser versus radiofrequency ablation. The ultrasound-guided ablation was performed in the operating room and followed by immediate excision, whole-mount pathology with proliferating cell nuclear antigen staining, and reconstruction.

Results

Twenty-one patients were enrolled onto the study. Fifteen patients received radiofrequency ablation, and all showed 100% ablation and negative margins. Magnetic resonance imaging was helpful in excluding multicentric disease but less so in predicting presence or absence of residual disease. Seven of these patients showed no residual tumor and eight showed residual dead tumor (0.5 ± 0.7 cm, range 0.1–2.5 cm) at the biopsy site with clear margins. The laser arm (3 patients) pathology demonstrated unpredictability of the ablation zone and residual live tumor.

Conclusions

This pilot study demonstrates the feasibility of a novel approach to minimally invasive therapy: percutaneous excision and effective cytoreduction, followed by radiofrequency ablation of margins for the treatment of breast cancer. Laser treatment requires further improvement.

Keywords

Proliferate Cell Nuclear Antigen Radiofrequency Ablation Doppler Imaging Ablation Zone Percutaneous Biopsy 

Notes

Acknowledgment

Supported by the Tenenbaum Breast Cancer Research Fund, Little Rock, Arkansas Supported by the Fashion Footwear Association of New York (FFANY/QVC) Supported by the National Institute of Health (NIH) Grant #5 R21-CA097715 in collaboration with Ethicon Endo-surgical, Inc and RITA/AngioDynamics.

Disclosure

V.S. Klimberg, MD has a grant with Angiodynamics for another project, “Multicenter Registry for eRFA.” Angiodynamics bought the RITA company that supplied the probes for this study through an NIH grant.

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Copyright information

© Society of Surgical Oncology 2011

Authors and Affiliations

  • V. Suzanne Klimberg
    • 1
    • 2
  • Cristiano Boneti
    • 1
  • Laura L. Adkins
    • 1
  • Maureen Smith
    • 1
  • Eric Siegel
    • 3
  • Vladimir Zharov
    • 4
  • Scott Ferguson
    • 4
  • Ronda Henry-Tillman
    • 1
  • Brian Badgwell
    • 5
  • Soheila Korourian
    • 2
  1. 1.Division of Breast Surgical Oncology, Department of SurgeryUniversity of Arkansas for Medical Sciences, Winthrop P. Rockefeller Cancer InstituteLittle RockUSA
  2. 2.Department of PathologyUniversity of Arkansas for Medical SciencesLittle RockUSA
  3. 3.Department of Biostatics, College of Public HealthUniversity of Arkansas for Medical Sciences, Winthrop P. Rockefeller Cancer InstituteLittle RockUSA
  4. 4.Phillips Classic Laser and Nanomedicine LaboratoriesUniversity of Arkansas for Medical Sciences, Winthrop P. Rockefeller Cancer InstituteLittle RockUSA
  5. 5.Department of SurgeryUniversity of Arkansas for Medical Sciences, Winthrop P. Rockefeller Cancer InstituteLittle RockUSA

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