Abstract
Background:
Widespread mammography has resulted in the increased detection of breast cancer <1.5
cm. It may be possible to treat these small tumors with in-situ laser ablation. Prior
to ablation tumor size is determined by ultrasound and mammogram. Histologic diagnosis
and determination of prognostic factors are obtained from image-guided needle core
samples. Invasive and in-situ tumors may be percutaneously ablated by a stereotactically
guided laser needle and subsequently evaluated by imaging methods and needle biopsy.
Methods
Fifty-four patients (50 invasive, 4 in-situ); 51 mass, 3 microcalcification; mean
diameter 12 (5 to 23) mm were treated by a stereotactically guided 805 nm laser beam
via a fiber in a 16G needle delivered to the cancer. One to 8 weeks later the coagulated
lesions were surgically removed for pathologic evaluation. In 2 additional patients,
the laser-treated tumors were not removed but were monitored by mammography, ultrasonography,
and needle core biopsy.
Results:
None of the patients sustained any adverse effect. The average treatment time was
30 minutes. Pathology analysis revealed a 2.5 to 3.5 hemorrhagic ring surrounding
the necrotic tumor. Under steady conditions, in two groups of 14 patients, 93% and
100% of the tumors showed complete destruction, with no residual cancer report. In
the 2 unresected cases kept under surveillance for 6 to 24 months, the laser-treated
tumors first showed shrinkage, followed by a 2 to 3 cm oil cyst. Fibrosis was demonstrated
on needle core biopsies.
Conclusions
Laser energy delivered through a stereotactically guided needle appears to ablate
mammographically detected breast cancer. A multicenter clinical trail is planned.
Keywords
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Article info
Publication history
Received in revised form:
May 27,
2002
Received:
May 6,
2002
Identification
Copyright
© 2002 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
