New data presented at the 13th Annual Meeting of the American Society of Breast Surgeons shows radiofrequency ablation can prevent local breast cancer recurrence just as effectively as radiation therapy. Compared to radiation therapy, radiofrequency ablation showed superior cosmetic results and poses little risk to healthy tissue.
A lumpectomy and axillary dissection being done through one incision. Image source: Chintamani et al.[1]As an adjunctive therapy, radiofrequency ablation, makes lumpectomy possible for patients who do not live near local radiation therapy sites.
Approximately 20% to 75% of breast surgery patients require subsequent surgeries to attain clear tumor margins. Radiation therapy following surgery helps to curb local recurrence rates, but is not without complications.
Additionally, radiation therapy can be very inconvenient, if not impossible, for patients in rural areas and for those with low incomes. Wilson stated that less than 80% of breast surgery patients receive the appropriate radiation treatment, making them more susceptible to local recurrences.
Misti Wilson, MD, Winthrop P. Rockefeller Cancer Institute at the University of Arkansas, presented the data.
Radiofrequency ablation is a new technique that uses high temperatures to create an added disease-free zone within the tumor cavity. The radiofrequency probe is typically placed into the tumor and the ablation is performed with ultrasound guidance in real time.
The 73-patient trial aimed to test whether extension of margins by 1 cm during surgery and subsequent radiofrequency ablation could decrease rates of a second surgery and could provide comparable therapeutic benefit and radiation therapy. All patients had early-stage disease with a median tumor size of 1 cm and negative lymph node status. All subjects were followed up for a median of 55 months.
Of the 73 patients, only 3 had to have a subsequent surgery. Moreover, 16 out of 19 patients (84%) with close, focally positive margins were spared reexcision. With 90% of patients having thus far showed good cosmetic results, this study suggests that radiofrequency ablation, done at the same time as the surgery, may replace radiotherapy in some patients.
Wilson highlighted the ongoing ABLATE trial that is ongoing at five centers. The study aims follow up the small current study to better determine whether radiofrequency ablation could decrease rates of second operations and to understand if cosmetic and quality of life outcomes are affected. The study aims to accrue 250 subjects.
References
1. Chintamani, Khandelwal R, Tandon M, et al. Carcinoma developing in a fibroadenoma in a woman with a family history of breast cancer: a case report and review of literature. Cases J. 2009;2:9348. PubMed
