Radiofrequency ablation (RFA)
Article date: 2001/11/29
Radiofrequency ablation (RFA) — a relatively new method of destroying tumors by heating them with energy waves similar to microwaves — is showing promise, say researchers in a report in Cancer (Vol. 92, No. 8: 2036-2044).
The authors write, "Our initial evaluation of RFA in the treatment of patients with early-stage breast carcinoma suggests that it should be studied further in patients with Stage I disease."
Steven A. Curley, MD, of M.D. Anderson Cancer Center in Houston and his colleagues say it´s not yet clear whether it´s a good treatment for patients with Stage II or larger tumors.
The researchers note that removing only the tumor (lumpectomy) and then radiating the breast has in recent years been shown to be as effective a treatment for early-stage breast cancer as mastectomy (surgical breast removal).
That awareness has increased interest in finding even less-invasive ways of treating early stage breast cancers. Success in treating liver tumors with RFA made researchers want to learn whether it could produce good results in breast cancer patients.
Technique´s Heat Destroys Tumors Cells
In the RFA method, doctors use ultrasound images on a monitor screen to guide a very thin metal needle through the patient´s skin into the tumor. The needle opens to extend extremely thin antennae-like probes in all directions from its tip.
Then radiofrequency energy passes through the probes into the tumor tissue, heating it hot enough to kill the tumor cells and a small rim of normal tissue — the safety "margin" — around them.
The researchers, at the G. Pascale National Tumor Institute in Naples, Italy, used the experimental treatment with 20 patients with Stage I and six women with Stage II breast tumors 3 cm or smaller.
Because the study was done to see whether the treatment is adequate to destroy the tumor and any adjacent cancerous tissue, after each woman was treated her tumor was surgically removed and tested to see if any cancer cells remained alive in or around it.
In 25 of the 26 patients, no cancerous cells were found alive in or around the removed tumor.
One patient´s removed tumor showed some cancer cells still alive near where the needle had been inserted.
Expert Says Method Doesn´t Yet Show an Advantage
The quest for improved treatments is and should be an always-ongoing one, notes Jeanne Petrek, MD, attending surgeon at Memorial Sloan Kettering Cancer Center in New York City.
But Petrek says that currently, RFA shows no advantage over surgical removal of a tumor, and involves some problems that surgery doesn´t.
Petrek, a member of the American Cancer Society´s breast cancer council, tells ACS News Today a major concern is how to know all the cancerous cells in and around the tumor have been killed, since outside clinical trials, the destroyed mass would be left inside the body.
She notes also that the RFA procedure requires general anesthesia because of the intense heat and burning, but a lumpectomy usually is done with a non-general anesthesia.
Lastly, she adds, there is a concern about whether the scar tissue formed by the burned tissue would prevent as good a cosmetic result as can be obtained now with lumpectomy and breast reconstruction.
"This is an interesting new technique that might have a niche somewhere, but its current limitations make it hard to see any advantage in breast cancer treatment over other methods already in use now," Petrek concludes.