Department of Surgery, Rinku General Medical Center, Izumisano, Osaka, Japan.
Department of Surgery, Wakayama Medical University Hospital, Wakayama, Japan.
Clin Breast Cancer. 2018 Aug;18(4):e495-e500. doi: 10.1016/j.clbc.2017.09.007. Epub 2017 Sep 25.
To validate the safety and efficacy of percutaneous radiofrequency ablation (RFA) of breast carcinomas.
This retrospective study was conducted by the Breast Cancer Society for Minimally Invasive Therapy following approval from institutional review boards, and with the written informed consent of patients. A total of 386 patients with breast cancer treated with RFA at 10 institutions between July 2003 and June 2009 were identified and included in the analysis. Patients underwent a standard RFA procedure with ultrasound guidance and were followed up every 6 to 12 months. In this study, feasibility of RFA procedure and related safety and ipsilateral breast tumor recurrence (IBTR) were examined. Fisher exact or χ test evaluated associations between clinicopathological factors and IBTR, and local recurrence-free survival was estimated using the Kaplan-Meier method.
RFA-related adverse events included local pain in 9 patients, skin burns in 15, and nipple retraction in 7. Patients were followed for a median of 50 months. IBTR was more frequently observed in patients with initial tumor sizes > 2 cm (3 of 30, 10%) than in those with initial tumors ≤ 2 cm (8 of 355, 2.3%; P = .015). IBTR-free rates 5 years after RFA were 97%, 94%, and 87% in patients with initial tumor sizes ≤ 1.0 cm, 1.1 to 2.0 cm, and > 2.0 cm, respectively.
RFA in breast cancer is a safe and promising minimally invasive treatment for tumors ≤ 2 cm in diameter. Further studies are needed to optimize the technique and evaluate its future role as local therapy.
验证经皮射频消融(RFA)治疗乳腺癌的安全性和有效性。
本回顾性研究经机构审查委员会批准,并获得患者书面知情同意后,由乳腺微创治疗学会开展。共纳入 2003 年 7 月至 2009 年 6 月间 10 家机构中 386 例接受 RFA 治疗的乳腺癌患者,并进行分析。患者接受标准的超声引导下 RFA 程序治疗,并每 6 至 12 个月随访一次。本研究中,评估了 RFA 程序的可行性及相关安全性和同侧乳房肿瘤复发(IBTR)情况。采用 Fisher 确切检验或 χ 检验评估临床病理因素与 IBTR 的相关性,采用 Kaplan-Meier 法估计局部无复发生存率。
RFA 相关不良事件包括 9 例局部疼痛、15 例皮肤灼伤和 7 例乳头内陷。患者中位随访时间为 50 个月。初始肿瘤大小>2 cm(3/30,10%)的患者较初始肿瘤大小≤2 cm(8/355,2.3%)的患者更常发生 IBTR(P=.015)。RFA 后 5 年,肿瘤初始大小≤1.0 cm、1.1 至 2.0 cm 和>2.0 cm 的患者 IBTR 无复发生存率分别为 97%、94%和 87%。
RFA 治疗直径≤2 cm 的乳腺癌是一种安全、有前景的微创治疗方法。需要进一步研究以优化该技术并评估其作为局部治疗的未来作用。