Radiofrequency ablation of small breast tumours: evaluation of a novel bipolar cool-tip application.

BACKGROUND Although radiofrequency ablation (RFA) is promising for the local treatment of breast cancer, burns are a frequent complication. The safety and efficacy of a new technique with a bipolar RFA electrode was evaluated. METHODS Dosimetry was assessed ex vivo in bovine mammary tissue, applying power settings of 5-15 W with 10-20 min exposure and 3.0-12.0 kJ to a 20-mm active length bipolar internally cooled needle-electrode. Subsequently, in 15 women with invasive breast carcinoma ≤2.0 cm diameter ultrasound-guided RFA was performed followed by immediate resection. RESULTS An ablation zone of 2.5 cm was reached in the ex vivo experiments at 15 W at 9.0 kJ administered energy. Histopathology revealed complete cell death in 10 of 13 patients (77%); in 3 patients partial ablation was due to inaccurate probe positioning. In 1 patient a pneumothorax was caused by the probe placement, treated conservatively. No burns occurred. CONCLUSIONS Ultrasound-guided RFA with a bipolar needle-electrode appears to be a safe local treatment technique for invasive breast cancer up to 2 cm. Ways to improve placement of the probe and direct monitoring of the ablation-effect should be the aim of further research.

[1]  D M Ikeda,et al.  Radiofrequency ablation of breast cancer: first report of an emerging technology. , 1999, Archives of surgery.

[2]  R. van Hillegersberg,et al.  Radiofrequency ablation for unresectable locally advanced pancreatic cancer: a systematic review. , 2014, HPB : the official journal of the International Hepato Pancreato Biliary Association.

[3]  André Roggan,et al.  Ex vivo evaluation of a bipolar application concept for radiofrequency ablation. , 2009, Anticancer research.

[4]  L. Organ.  Electrophysiologic principles of radiofrequency lesion making. , 1976, Applied neurophysiology.

[5]  I. Olivotto,et al.  Treatment of invasive breast carcinoma with ultrasound-guided radiofrequency ablation. , 2003, American journal of surgery.

[6]  S. Singletary,et al.  Small (< or = 2-cm) breast cancer treated with US-guided radiofrequency ablation: feasibility study. , 2004, Radiology.

[7]  D. Fraker,et al.  Magnetic resonance imaging-guided biopsy of mammographically and clinically occult breast lesions. , 2002 .

[8]  J. Szejnfeld,et al.  Analysis by MRI of residual tumor after radiofrequency ablation for early stage breast cancer. , 2012, AJR. American journal of roentgenology.

[9]  J. McGahan,et al.  A Phase II Trial of Image-Guided Radiofrequency Ablation of Small Invasive Breast Carcinomas: Use of Saline-Cooled Tip Electrode , 2007, Annals of Surgical Oncology.

[10]  C. Robles-Vidal,et al.  Radiofrequency Ablation of Invasive Breast Carcinomas: A Phase II Trial , 2008, Annals of Surgical Oncology.

[11]  W. Helton,et al.  Radiofrequency ablation of primary and metastatic liver tumors: a critical review of the literature. , 2008, American journal of surgery.

[12]  G. Manenti,et al.  Small breast cancers: in vivo percutaneous US-guided radiofrequency ablation with dedicated cool-tip radiofrequency system. , 2009, Radiology.

[13]  K. Bloom,et al.  Pathologic changes after interstitial laser therapy of infiltrating breast carcinoma. , 2001, American journal of surgery.

[14]  R. Gupta,et al.  Use of a multiparametric panel to target subpopulations in a heterogeneous solid tumor model for improved analytical accuracy. , 1995, Cytometry.

[15]  M. Mathieu,et al.  Doppler US with perfusion software and contrast medium injection in the early evaluation of radiofrequency in breast cancer recurrences: a prospective phase II study. , 2005, European journal of radiology.

[16]  Eben Kermit,et al.  MRI‐guided radiofrequency ablation of breast cancer: Preliminary clinical experience , 2008, Journal of magnetic resonance imaging : JMRI.

[17]  M. Noguchi,et al.  Radiofrequency ablation therapy for small breast cancer followed by immediate surgical resection or delayed mammotome excision , 2007, Breast cancer.

[18]  F. Izzo,et al.  Radiofrequency ablation in patients with primary breast carcinoma , 2001, Cancer.

[19]  M. Earashi,et al.  Long-term outcome of breast cancer patients treated with radiofrequency ablation. , 2012, European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology.

[20]  Stephen P Povoski,et al.  Radiofrequency ablation of invasive breast carcinoma followed by delayed surgical excision , 2003, Cancer.

[21]  M. Noguchi,et al.  Radiofrequency ablation of small breast cancer followed by surgical resection , 2006, Journal of surgical oncology.

[22]  R. Nakamura,et al.  Pilot study of radiofrequency ablation therapy without surgical excision for T1 breast cancer: evaluation with MRI and vacuum-assisted core needle biopsy and safety management , 2011, Breast cancer.

[23]  B. Grotenhuis,et al.  Radiofrequency ablation for early-stage breast cancer: treatment outcomes and practical considerations. , 2013, European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology.

[24]  G. Tzovaras,et al.  The Fat Content of Small Primary Breast Cancer Interferes with Radiofrequency-Induced Thermal Ablation , 2008, European Surgical Research.

[25]  T. Yoshimasu,et al.  Radiofrequency ablation therapy in patients with breast cancers two centimeters or less in size , 2007, Breast cancer.

[26]  R. Elliott,et al.  Stereotactic radiofrequency ablation: a minimally invasive technique for nonpalpable breast cancer in postmenopausal patients. , 2009, Cancer epidemiology.

[27]  T. Hasebe,et al.  Feasibility study on radiofrequency ablation followed by partial mastectomy for stage I breast cancer patients. , 2009, Breast.

[28]  T. Kinoshita,et al.  Radiofrequency ablation as local therapy for early breast carcinomas , 2011, Breast cancer.

[29]  R Holland,et al.  Breast carcinomas of limited extent , 2001, Cancer.

[30]  G. Auer,et al.  Feasibility study on the treatment of small breast carcinoma using percutaneous US-guided preferential radiofrequency ablation (PRFA). , 2010, Breast.

[31]  H. Bartelink,et al.  Pre-treatment imaging and pathology characteristics of invasive breast cancers of limited extent: potential relevance for MRI-guided localized therapy. , 2012, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[32]  K. Bosscha,et al.  Use of cytokeratin 8 immunohistochemistry for assessing cell death after radiofrequency ablation of breast cancers , 2011, Biotechnic & histochemistry : official publication of the Biological Stain Commission.

[33]  S. Singletary,et al.  Feasibility of radiofrequency ablation for primary breast cancer , 2003, Breast cancer.

[34]  M. A. van den Bosch,et al.  7 T versus 3T contrast-enhanced breast magnetic resonance imaging of invasive ductulolobular carcinoma: first clinical experience. , 2013, Magnetic resonance imaging.