Stereotactic radiofrequency ablation: A minimally invasive technique for nonpalpable breast cancer in postmenopausal patients

Background: The purpose of this study was to determine the feasibility of radiofrequency ablation (RFA) of nonpalpable breast cancer in postmenopausal women, and report on long-term follow-up with clinical examination and mammography. Methods: Since November 2000, we have performed RFA on stereotactically localized nonpalpable breast cancers (only mammographic densities) in women older than 65 years with other serious health problems. Results: The first patient had the procedure done in the office with sedation and local anesthesia. The radiofrequency probe was inserted by stereotactic localization, and the RFA proceeded for 20 min at 75 °C. Two weeks later, the lesion was not seen mammographically, but by palpation there was induration at the ablation site. Six weeks later, open excision of the area confirmed a prominent ablation site with no remaining viable tumor cells. The second patient had the same procedure, and has been followed without open biopsy. The third patient had DCIS and the probe arrays were not able to penetrate the lesion. The fourth and fifth patients had light sedation with an intercostal nerve block to eliminate discomfort and this approach was found to be a very effective office procedure. The last two patients’ ablation sites were injected with depo-medrol and they were placed on anti-inflammatory therapy to decrease the palpable induration caused by fat necrosis. Conclusion: We found RFA feasible for definitive therapy for nonpalpable breast cancer. If our results are confirmed by larger clinical trials, RFA would eliminate open surgery and decrease the morbidity associated with lumpectomy and radiation.