Background: The aim of this study was to compare the efficacy of radiofrequency ablation vs. cryoablation in the treatment of early breast cancer. Patients and Methods:80 women (mean age 73 ± 5 years) with early breast cancer were retrospectively evaluated. 40 patients underwent cryoablation and 40 patients underwent radiofrequency ablation, both with sentinel lymph node excision. Tumor volume and histopatological data were compared by means of postprocedural 3.0-T magnetic resonance imaging (MRI). 30-45 days after the percutaneous ablation, all patients underwent surgical resection of the tumor. The mean follow-up was 18 months without any local recurrences. Results: Both techniques allow good correlation with histopathological data. In 75 patients (93.8%) we observed complete necrosis; in 5 cases there was residual disease in the postprocedural MRI and postoperative histological examination. There was a good correlation between MRI volume and histologic samples. Cosmetic results were good in all patients but 2. Conclusion: Both percutaneous radiofrequency ablation and cryotherapy are minimally invasive techniques with a good clinical and cosmetic outcome in selected cases. MRI examination is an ideal method to assess breast neoplasms in terms of quality and quantity as well as residual tumor extent after percutaneous ablation. Cryotherapy is the preferred method because of the analgesic effect of freezing with better patients compliance.

Keywords:
Cryoablation, Radiofrequency ablation, Breast cancer, Percutaneous ablation, MRI, Minimally invasive techniques
1.
Veronesi U, Cascinelli N, Mariani L: Twenty-years follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med 2002;347:1227-32.
2.
Kimmick GG, Balducci L: Breast cancer and aging. Clinical interactions. Hematol Oncol Clin North Am 2000;14:213-34.
3.
Parkin DM, Bray FI, Devesa SS: Cancer burden in the year 2000. The global picture. Eur J Cancer 2000;37:S4-S66.
4.
Fornage BD, Sneige N, et al.: Small (< or = 2-cm) breast cancer treated with US-guided radiofrequency ablation: feasibility study. Radiology 2004;231:215-24.
5.
Littrup PJ, Jallad B, Vorugu V: Lethal isotherms of cryoablation in a phantom study: effects of heat load, probe size and number. J Vasc Interv Radiol 2009;20:1343-51.
6.
Manenti G, Bolacchi F, Perretta T, et al.: Small breast cancers: in vivo percutaneous US-guided radiofrequency ablation with dedicated cool-tip radiofrequency system. Radiology 2009;251:339-46.
7.
Stijn van Esser M, van den Bosch AJ, van Diest P, et al.: Minimally invasive ablative therapies for invasive breast carcinomas: an overview of current literature. World J Surg 2007;31:2284-92.
8.
Carlson RW, Hudis CA, Pritchard KI; National Comprehensive Cancer Network Breast Cancer Clinical Practice Guidelines in Oncology. American Society of Clinical Oncology Technology Assessment on the Use of Aromatase Inhibitors; St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer: Adjuvant endocrine therapy in hormone receptor-positive postmenopausal breast cancer: evolution of NCCN, ASCO, and St Gallen recommendations. J Natl Compr Canc Netw 2006;4:971-9.
9.
Van der Ploeg IM, van Esser S, van den Bosch MA, et al.: Radiofrequency ablation for breast cancer: a review of the literature. Eur J Surg Oncol 2007;33:673-7.
10.
Van Esser S, van den Bosch MA, van Diest PJ, Mali WT, Borel Rinkes IH, van Hillegersberg R: Minimally invasive ablative therapies for invasive breast carcinomas: an overview of current literature. World J Surg 2007;31:2284-92.
11.
Manenti G, Perretta T, Gaspari E, et al.: Percutaneous local ablation of unifocal subclinical breast cancer: clinical experience and preliminary results of cryotherapy. Eur Radiol 2011;21:2344-53.
12.
Singletary SE: Surgical margins in patients with early-stage breast cancer treated with breast conservation therapy. Am J Surg 2002;184:383-93.
13.
Ellis MJ, Tao Y, Luo J, et al.: Outcome prediction for estrogen receptor-positive breast cancer based on postneoadjuvant endocrine therapy tumor characteristics. J Natl Cancer Inst 2008;100:1380-8.
14.
Yoshinaga Y, Enomoto Y, Fujimitsu R: Image and pathological changes after radiofrequency ablation of invasive breast cancer: a pilot study of non surgical therapy of early breast cancer. World J Surg 2013;37:356-63.
15.
Vlastos G, Verkooijen H: Minimally invasive approaches for diagnosis and treatment of early-stage breast cancer. Oncologist 2007;12:1-10.
16.
Goldberg SN, Gazelle GS, Halpern EF, Rittman WJ, Mueller PR, Rosenthal DI: Radiofrequency tissue ablation: importance of local temperature along the electrode tip exposure in determining lesion shape and size. Acad Radiol 1996;3:212-8.
© 2013 S. Karger GmbH, Freiburg
2013
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.