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Ultrasound-guided percutaneous microwave ablation for 755 benign breast lesions: a prospective multicenter study

  • Oncology
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To evaluate the clinical efficacy of microwave ablation (MWA) of benign breast lesions (BBLs) and compare the learning curves of international radiologists (IRs) and surgeons.

Methods

In total, 440 patients with 755 clinicopathologically confirmed BBLs from 5 centers were prospectively enrolled from February 2014 to July 2018. Technical success, complications, volume reduction ratio (VRR), palpability, and cosmetic satisfaction after ablation were analyzed. In addition, the ablation time (AT) and energy (AE) with the number of procedures were analyzed for learning curve evaluation.

Results

The mean maximum diameter was 1.7 ± 0.6 cm. The complete ablation rate reached 100%, including 45.8% lesions adjacent to the skin, pectoralis, or areola. After a median follow-up of 13.7 months, the 12-month VRR of all lesions was 97.9%, and that for 1.0- to 2.0-cm and ≥ 2.0-cm lesions was 98.6% and 96.9%, respectively. A total of 55.9% of BBLs became nonpalpable (palpable in 85.7% of cases before MWA) by both the clinician and patient. The cosmetic and minimally invasive satisfaction rates were good or excellent in 98.4% and 94.5% of patients, respectively. The median AT/cm3 and AE/cm3 decreased as experience increased. The AE/cm3 of the IR with 5 years of experience was lower than that of the IR with 1 year of experience and the surgeons, while the AT/cm3 of surgeons was comparable with that of the IR with 5 years of experience at relatively mature phase.

Conclusions

Ultrasound-guided percutaneous MWA is a valuable technique for the treatment of BBLs.

Trial registration: ClinicalTrials.gov (NCT02860104)

Key Points

• Ultrasound-guided percutaneous microwave ablation has the potential to become a valuable technique for the treatment of benign breast lesions.

• A skilled interventional radiologist shows a rapid improvement in mastering the technique.

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Abbreviations

AE:

Ablation energy

AP:

Ablation power

AT:

Ablation time

BBL:

Benign breast lesion

BI-RADS:

Breast Imaging Recording and Data System

CEMRI:

Contrast-enhanced magnetic resonance imaging

CEUS:

Contrast-enhanced US

IR:

Interventional radiologist

LC:

Learning curve

MWA:

Microwave ablation

US:

Ultrasound

VRR:

Volume reduction ratio

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Acknowledgments

We thank the participants and staff of the Department of Interventional Ultrasound, Chinese PLA General Hospital, for their valuable contributions.

Funding

This work was supported by Grant JQ18021 from the National Scientific Foundation Committee of Beijing; Grants 81627803, 81971625, and 91859201 from the National Scientific Foundation Committee of China, Fostering Funds for National Distinguished Young Scholar Science Fund, and the National Clinical Research Center for Geriatric Diseases (NCRCG-PLAGH-2019011) of Chinese PLA General Hospital; and Grant 2018ZX10723-204 from the National Key R&D Program of Ministry of Science and Technology of China.

Author information

Author notes

  1. Jie Yu and Ping Liang contributed equally and are joint senior authors.

Authors and Affiliations

  1. Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China

    Qi Yang, Han Wu, Jian-ping Dou, Zhi-yu Han, Jing Zhang, Xiao-ling Yu, Jie Yu & Ping Liang

  2. Department of Breast Surgery, The Affiliated Hospital of Putian University, 999 Dongzhen Road, Putian City, 351100, Fujian, China

    Hang Li

  3. Department of General Surgery, The No. 908 Hospital of Joint Logistics Support Force, Yingtan, China

    Bao-hua Chen

  4. Department of Ultrasound, University of Chinese Academy of Sciences Shenzhen Hospital, 4253 Songbai Road, Matian Street, Guangming District, Shenzhen, Guangdong Province, China

    Guang-zhi He

  5. Department of Breast Surgery, Zhangzhou Zhengxing Hospital, 1609 North Huancheng Road, Zhangzhou, China

    Xiu-ping Wu

  6. Department of Ultrasound, Gansu Provincial Hospital, Lanzhou, 730000, China

    Li-xia Wang

Authors
  1. Qi Yang
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Corresponding authors

Correspondence to Jie Yu or Ping Liang.

Ethics declarations

Guarantor

The scientific guarantor of this publication is Ping Liang and Jie Yu.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

Study subjects or cohorts overlap

Some study subjects or cohorts have been previously reported in Oncotarget and International Journal of Hyperthermia.

Methodology

• Prospective

• Observational

• Multicenter study

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Yang, Q., Li, H., Chen, Bh. et al. Ultrasound-guided percutaneous microwave ablation for 755 benign breast lesions: a prospective multicenter study. Eur Radiol 30, 5029–5038 (2020). https://doi.org/10.1007/s00330-020-06868-9

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  • DOI: https://doi.org/10.1007/s00330-020-06868-9

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