World Journal of Surgery

, Volume 37, Issue 2, pp 356–363 | Cite as

Image and Pathological Changes after Radiofrequency Ablation of Invasive Breast Cancer: A Pilot Study of Nonsurgical Therapy of Early Breast Cancer

  • Yasuteru YoshinagaEmail author
  • Yasuko Enomoto
  • Ritsuko Fujimitsu
  • Mikiko Shimakura
  • Kazuki Nabeshima
  • Akinori Iwasaki



The surgical treatment of early breast cancer has proceeded to less invasive approaches with better cosmetic results. The current study was undertaken to evaluate the clinical and pathological findings after radiofrequency ablation (RFA) without resection for a longer period of time.


A total of 14 patients with breast cancer were enrolled. All patients were diagnosed to have invasive ductal carcinoma, and the median breast tumor size was 12 mm (range, 6–20 mm). Six patients received RFA treatment followed by immediate resection and eight patients without resection. The patients without resection were evaluated by ultrasound, MRI, and the pathological findings of a core needle biopsy after RFA. The removed specimens were examined by hematoxylin-eosin (HE) staining and nicotinamide adenine dinucleotide (NADH) diaphorase staining. The median follow-up of the patients was 39.9 months.


NADH staining was necessary to diagnose complete tumor cell death in the tissue for 3 months after RFA. However, HE staining alone could confirm the effect without NADH staining more than 6 months after RFA. Post-RFA, MRI scans clearly demonstrated the area as a complete ablated lesion in all patients without resection. The ablated area detected by MRI or ultrasound became gradually smaller. All patients that underwent RFA with no resection were alive without relapse.


RFA therefore could be an effective alternative to partial mastectomy for early breast cancer. Further research will be necessary to establish the standardization of the indications, as well as the optimal techniques and post treatment evaluation modalities.


Breast Cancer Sentinel Node Sentinel Lymph Node Biopsy Early Breast Cancer Core Needle Biopsy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Singletary SE (2007) Multidisciplinary frontiers in breast cancer management: a surgeon’s perspective. Cancer 109(6):1019–1029PubMedCrossRefGoogle Scholar
  2. 2.
    Veronesi U, Cascinelli N, Mariani L et al (2002) Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med 347(16):1227–1232PubMedCrossRefGoogle Scholar
  3. 3.
    Fisher B, Anderson S, Bryant J et al (2002) Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med 347(16):1233–1241PubMedCrossRefGoogle Scholar
  4. 4.
    Wazer DE, DiPetrillo T, Schmidt-Ullrich R et al (1992) Factors influencing cosmetic outcome and complication risk after conservative surgery and radiotherapy for early-stage breast carcinoma. J Clin Oncol 10(3):356–363PubMedGoogle Scholar
  5. 5.
    Al-Ghazal SK, Blamey RW, Stewart J et al (1999) The cosmetic outcome in early breast cancer treated with breast conservation. Eur J Surg Oncol 25(6):566–570PubMedCrossRefGoogle Scholar
  6. 6.
    Nissen MJ, Swenson KK, Ritz LJ et al (2001) Quality of life after breast carcinoma surgery a comparison of three surgical procedures. Cancer 91(7):1238–1246PubMedCrossRefGoogle Scholar
  7. 7.
    Waljee JF, Hu ES, Ubel PA et al (2008) Effect of esthetic outcome after breast-conserving surgery on psychosocial functioning and quality of life. J Clin Oncol 26(20):3331–3337PubMedCrossRefGoogle Scholar
  8. 8.
    Jeffrey SS, Birdwell RL, Ikeda DM et al (1999) Radiofrequency ablation of breast cancer: first report of an emerging technology. Arch Surg 134(10):1064–1068PubMedCrossRefGoogle Scholar
  9. 9.
    Noguchi M, Earashi M, Fujii H et al (2006) Radiofrequency ablation of small breast cancer followed by surgical resection. J Surg Oncol 93(2):120–128PubMedCrossRefGoogle Scholar
  10. 10.
    Wu F, Wang Z-B, Cao Y-D et al (2003) A randomised clinical trial of high-intensity focused ultrasound ablation for the treatment of patients with localised breast cancer. Br J Cancer 89(12):2227–2233PubMedCrossRefGoogle Scholar
  11. 11.
    Sabel MS, Kaufman CS, Whitworth P et al (2004) Cryoablation of early-stage breast cancer: work-in-progress report of a multi-institutional trial. Ann Surg Oncol 11(5):542–549PubMedCrossRefGoogle Scholar
  12. 12.
    Sutherland LM, Williams JA, Padbury RT et al (2006) Radiofrequency ablation of liver tumours: systematic review. Arch Surg 5(2):181–190CrossRefGoogle Scholar
  13. 13.
    Medina-Franco H, Soto-Germes S, Ulloa-Gómez JL et al (2008) Radiofrequency ablation of invasive breast carcinomas: a phase II trial. Ann Surg Oncol 15(6):1689–1695PubMedCrossRefGoogle Scholar
  14. 14.
    Imoto S, Wada N, Sakemura N et al (2009) Feasibility study on radiofrequency ablation followed by partial mastectomy for stage I breast cancer patients. Breast 18(2):130–134PubMedCrossRefGoogle Scholar
  15. 15.
    Kinoshita T, Iwamoto E, Tsuda H et al (2011) Radiofrequency ablation as local therapy for early breast carcinomas. Breast cancer 18(1):10–17PubMedCrossRefGoogle Scholar
  16. 16.
    Burak WE, Agnese DM, Povoski SP et al (2003) Radiofrequency ablation of invasive breast carcinoma followed by delayed surgical excision. Cancer 98(7):1369–1376PubMedCrossRefGoogle Scholar
  17. 17.
    Ohtani S, Kochi M, Ito M et al (2011) Radiofrequency ablation of early breast cancer followed by delayed surgical resection—a promising alternative to breast-conserving surgery. Breast 20(5):431–436PubMedCrossRefGoogle Scholar
  18. 18.
    Oura S, Tamaki T, Hirai I et al (2007) Radiofrequency ablation therapy in patients with breast cancers two centimeters or less in size. Breast cancer 14(1):48–54PubMedCrossRefGoogle Scholar
  19. 19.
    Yamamoto N, Fujimoto H, Nakamura R et al (2011) Pilot study of radiofrequency ablation therapy without surgical excision for T1 breast cancer: evaluation with MRI and vacuum-assisted core needle biopsy and safety management. Breast Cancer 18(1):3–9PubMedCrossRefGoogle Scholar
  20. 20.
    Yoshinaga Y, Hagio Y, Fukuyo M et al (2010) Micrometastasis of breast cancer in the sentinel lymph nodes. Med Bull Fukuoka Univ 37(2):67–72Google Scholar
  21. 21.
    Goldhirsch A, Ingle JN, Gelber RD et al (2009) Thresholds for therapies: highlights of the St Gallen International Expert Consensus on the primary therapy of early breast cancer 2009. Ann Oncol 20(8):1319–1329PubMedCrossRefGoogle Scholar
  22. 22.
    Yang SK, Moon WK, Cho N et al (2007) Screening mammography-detected cancers: sensitivity of a computer-aided detection system applied to full-field digital mammograms. Radiology 244(1):104–1011PubMedCrossRefGoogle Scholar
  23. 23.
    The JS, Schilling KJ, Hoffmeister JW et al (2009) Detection of breast cancer with full-field digital mammography and computer-aided detection. AJR Am J Roentgenol 192(2):337–340PubMedCrossRefGoogle Scholar
  24. 24.
    Krag DN, Anderson SJ, Julian TB et al (2010) Sentinel-lymph-node resection compared with conventional axillary-lymph-node dissection in clinically node-negative patients with breast cancer: overall survival findings from the NSABP B-32 randomised phase 3 trial. Lancet Oncol 11(10):927–933PubMedCrossRefGoogle Scholar
  25. 25.
    Zhao Z, Wu F (2010) Minimally invasive thermal ablation of early-stage breast cancer: a systemic review. Euro J Surg Oncol 36:1149–1155CrossRefGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2012

Authors and Affiliations

  • Yasuteru Yoshinaga
    • 1
    Email author
  • Yasuko Enomoto
    • 1
  • Ritsuko Fujimitsu
    • 2
  • Mikiko Shimakura
    • 2
  • Kazuki Nabeshima
    • 3
  • Akinori Iwasaki
    • 1
  1. 1.Department of General Thoracic, Breast and Pediatric Surgery, School of MedicineFukuoka UniversityFukuokaJapan
  2. 2.Department of Radiology, School of MedicineFukuoka UniversityFukuokaJapan
  3. 3.Department of Pathology, School of MedicineFukuoka UniversityFukuokaJapan

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