Edward Lam Shang Leen MD, Presenter: Research support, Bristol-Myers Squibb Company

Karen Pope MBChB, Abstract Co-Author: Nothing to Disclose

Elizabeth Mallon MRCP, Abstract Co-Author: Nothing to Disclose

Timothy Cooke MD, PhD, Abstract Co-Author: Research funded, Tyco Healthcare

To assess the effectiveness and safety of Radiofrequency ablation of breast carcinoma and to evaluate the use of contrast enhanced ultrasound (CEUS) in the evaluation of response to ablation immediately following the procedure.

10 patients with proven breast carcinoma scheduled for mastectomy or wide local excision plus axillary procedure were studied. Radiofrequency ablation of the tumour under ultrasound guidance was performed under general anaesthetic, immediately prior to the definitive surgery. Contrast enhanced ultrasound (CEUS) was performed prior to and 10 minutes after the ablation to assess the tumour and ablation zone microcirculation respectively using Philips IU22, L9-3 linear probe with non-linear imaging mode after iv injection of 2.4ml of SonoVue. Specimens obtained after surgery were then analysed pathologically using H&E staining, and representative tissue was snap frozen for cell vitality staining (NADH-diaphorase), to assess the effect of the thermal ablation.

Basic H&E stain revealed a heterogenous pattern of apparently viable cells in 90% of cases, interspersed with non-viable cells within the zone of ablation. However NADH-diaphorase cell vitality testing showed no viable cells within the ablated regions and margins in all patients. Using time-intensity curves assessment, CEUS showed increase in perfusion at the tumour and/or its periphery, compared to normal breast tissue prior to ablation. Following ablation, there was complete absence of perfusion in the ablation zone and margins associated reactive hyperaemia of the overlying skin and subcutaneous layers in all cases. One patient developed a seroma related to the surgery itself.

Radiofrequency Ablation is a safe and effective technique in producing tumour cell death. CEUS is effective in assessing immediate response following ablation.

Radiofrequency ablation may be an effective alternative treatment option for breast cancer patients unsuitable/unfit for surgery.

Leen, E, Pope, K, Mallon, E, Cooke, T, Radiofrequency Ablation of Breast Carcinoma and Assessment of Ablation Zone: Preliminary Study.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5003884.html