Peek M C L, Ahmed M, Scudder J, Baker R, Pinder S E, Douek M
a Division of Cancer Studies , King's College London , London , UK.
b Guy's and St Thomas' NHS Foundation Trust , London , UK.
Int J Hyperthermia. 2016 Dec;32(8):881-888. doi: 10.1080/02656736.2016.1212278. Epub 2016 Sep 7.
Breast fibroadenomata (FAD) are the most common breast lumps in women. High intensity focused ultrasound (HIFU) is a non-invasive ablative technique that can be used to treat FAD but is associated with prolonged treatment times. In the HIFU-F trial, we evaluated the change in volume over time with circumferential HIFU treatment of FAD and compared this to no treatment.
Patients ≥18 years, diagnosed with symptomatic, palpable FAD, visible on ultrasound (US) were recruited. Twenty patients were treated using US-guided HIFU under local anaesthesia. Another 20 participants underwent an US 6 months after diagnosis. Outcome measures included: reduction in treatment time compared to whole lesion ablation; feasibility to achieve a 50% reduction in volume after 6 months; decrease in volume compared to a control group and reduction in symptoms.
Circumferential ablation reduced the mean treatment time by 37.5% (SD 20.1%) compared to whole lesion ablation. US demonstrated a significant mean reduction in FAD volume of 43.5% (SD 38.8%; p = 0.016, paired t-test) in the HIFU group compared to 4.6% (SD 46.0%; p = 0.530) in the control group after 6 months. This mean reduction in FAD volume between the two groups was significant in favour of the HIFU group (p = 0.002, grouped t-test). Pre-treatment pain completely resolved in 6 out of 8 patients 6 months post-treatment.
Circumferential HIFU ablation of FAD is feasible, with a significant reduction in pain and volume compared to control participants. It provides a simple, non-invasive, outpatient-based alternative to surgical excision for FAD.
乳腺纤维腺瘤（FAD）是女性最常见的乳腺肿块。高强度聚焦超声（HIFU）是一种可用于治疗FAD的非侵入性消融技术，但治疗时间较长。在HIFU-F试验中，我们评估了采用环形HIFU治疗FAD时体积随时间的变化，并将其与未治疗的情况进行比较。
招募年龄≥18岁、经超声（US）检查确诊为有症状、可触及的FAD患者。20例患者在局部麻醉下采用超声引导下的HIFU进行治疗。另外20名参与者在诊断后6个月接受超声检查。结果指标包括：与整个病灶消融相比治疗时间的缩短；6个月后体积减少50%的可行性；与对照组相比体积的减小以及症状的减轻。
与整个病灶消融相比，环形消融使平均治疗时间缩短了37.5%（标准差20.1%）。超声显示，6个月后，HIFU组FAD体积平均显著减少43.5%（标准差38.8%；p = 0.016，配对t检验），而对照组为4.6%（标准差46.0%；p = 0.530）。两组之间FAD体积的平均减少在HIFU组显著更有利（p = 0.002，成组t检验）。8例患者中有6例在治疗后6个月疼痛完全缓解。
FAD的环形HIFU消融是可行的，与对照组相比，疼痛和体积显著减少。它为FAD的手术切除提供了一种简单、非侵入性、基于门诊的替代方法。
