【摘 要】
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Background: The prognosis of approximately 60% of the breast cancer patients depends on the local treatment alone.Breast conserving therapy has been proved to be as good as mastectomy for breast cance
【机 构】
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Department of Breast Surgical Oncology Breastopia Namba Hospital Japan
【出 处】
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(BITs 3rd Annual World Cancer Congress-2010, Breast Cancer C
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Background: The prognosis of approximately 60% of the breast cancer patients depends on the local treatment alone.Breast conserving therapy has been proved to be as good as mastectomy for breast cancer in several clinical trials.MRI is the best modality in spatial resolution for the detection of breast cancer ductal spread.Two phase Ⅱ clinical studies (excision studies) to investigate pathological efficacy and clinical safety of MR guided focused ultrasound surgery (MRgFUS) were conducted and their outcome has been published.Purpose: To inspect the efficacy and safety of MRgFUS followed by radiotherapy in excisionless study.Methods: The inclusion criteria include: 1) tumor diagnosed by needle biopsy under ultrasound; 2) HER-2, HR status confirmation; 3) tumor size 15mm; 4) well demarcated mass in contrast enhanced MRI.The exclusion criteria include: 1) pure type mucinous carcinoma; 2) invasive micropapillary carcinoma; 3) skin dimple or dimpling sign, previous surgical scar of the skin above the tumor; 4) location of the tumor requires a high sonication angle.Needle biopsy was performed again within three weeks after ablation and no residual viable cancer cells were identified by HE and single strand DNA immunohistochemical stain.The following radiotherapy is whole breast (50Gy) and boost(10Gy).Results: Fifty three patients were recruited in this study and forty-three lesions were treated from April 2005 to February 2010.The median age was 57 years old (37-72).The average tumor size was 11.0mm (6-15).The median follow up period was 37 months (1-56).Thirty three cases were followed up for more than 24 months.There were no severe adverse events and no local and distant recurrence cases.Conclusions: Although the number of cases is still small and the follow-up period is short, MRgFUS has the potential of replacing usual breast conserving surgery.Strict selection of cases is essential.
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