VAB and MRI Following Percutaneous Ultra-Sound Guided Cryoablation for Primary Early-Stage Breast Cancer: A Pilot Study in Japan

Autor: Arata Shimo, Ai Motoyoshi, Yoshihide Kanemaki, Hidefumi Mimura, Reiko Yoshie, Yasuyuki Kojima, Koichiro Tsugawa, Hisanori Kawamoto, Ei Haku, Akihiko Suto, Mizuho Tazo, Yukari Yabuki, Mari Hara Nakano, Mamoru Fukuda, Ichiro Maeda, Mariko Takishita, Ayaka Shimo, Ryoko Oi, Takako Kuroda, Tsuguo Iwatani, Tomoko Tsuruga
Rok vydání: 2021
Předmět:
Zdroj: Journal of Cancer Therapy. 12:563-576
ISSN: 2151-1942
2151-1934
DOI: 10.4236/jct.2021.1210047
Popis: Objective: This study aimed to evaluate the feasibility, safety, and cosmetic outcomes of percutaneous cryoablation (PCA) of breast intraductal carcinoma (IDC) lesions, as well as post-cryoablation magnetic resonance imaging (MRI) as a follow-up tool for detection of residual malignancies and local recurrences. Methods: Eight female patients underwent percutaneous ultrasound-guided cryoablation of breast IDC tumors under local anesthesia without subsequent resection. All patients received radiation- and endocrine therapies (RT, ET). The patients were followed using vacuum-assisted biopsy (VAB), mammography (MG), magnetic resonance imaging (MRI), and Moire Topography for cosmetic outcomes. VAB was performed 6 months following cryoablation treatment for cases 1 and 2 (after starting radiation- and endocrine-therapies) or one month after PCA (cases 3, 4, 5, 6 and 7), prior to RT and ET. One patient declined VAB. Results: Mean age of the patients was 61.9 years, SD 7.7, ages range 53 - 72 years. Mean tumor size was 10.3 mm, SD 2.74, ranged 6.8 - 14.5 mm, median follow-up time was 28 months (range 13 - 34 months). No residual or recurrent malignancies were detected. One minor adverse event was observed: A skin redness in the ablated area; MRI at one-month post-cryotherapy showed various degrees of thermal burns in all patients in the pectoralis major muscle, which were not symptomatic and were resolved by 6 months following PCA. Decrease of fat necrosis areas in the vicinity of ablated ex-tumor was traced with MRI (mean size 54.9 mm, mean decrease after 2 years was 58%) and validated with VAB. Conclusions: Percutaneous cryoablation of early-stage low-risk breast cancer tumors smaller than 15 mm potentially presents a potential substitute for lumpectomy, offering encouraging short- to mid-term oncology results with good cosmesis outcomes. Patients would be able to benefit from local anesthesia in an outpatient setting and a shorter recovery period.
Databáze: OpenAIRE
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