Radiofrequency ablation for minimally invasive treatment of breast carcinoma. A pilot study in elderly inoperable patients

Objectives.Radiofrequency ablation (RFA) has been used to treat hepatic, renal and prostate tumors. Preliminary experiences in breast cancer, followed by surgical excision, were encouraging. We performed a pilot trial of ultrasound-guided percutaneous RFA, not followed by surgery, in three elderly inoperable patients with breast carcinoma. The study was undertaken to determine the feasibility of treating small breast malignancies with RFA only and to evaluate the safety and complications related to this treatment.Methods.Three patients with core-needle biopsy-proven invasive carcinoma (< 2 cm in greatest dimension) underwent ultrasound-guided RFA under local anesthesia, as outpatient procedure. Treatment was planned to ablate the tumor and a margin of surrounding breast tissue. All the patients were evaluated after a 1, 6, 12 and 18 months of follow-up.Results.All the patients completed the treatment with minimal or no discomfort and returned home after 1 h. The mean age was 81.3 years (range, 76–86 years) and the mean tumor size was 11.6 mm (range, 10–13 mm). The tumors laid more than 10 mm from chest wall and from the skin. The mean time required for ablation was 10.3 min (range, 8–12 min). There were no treatment-related complications. Post-ablation ultrasound scan, mammography, Magnetic Resonance Imaging scan and core biopsy, confirmed the tumor necrosis. After 18 months of follow-up no recurrence occurred.Conclusions.RFA was feasible and safe for minimally invasive treatment of elderly inoperable patients with early-stage, primary breast carcinoma.