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Percutaneous US-guided Radiofrequency Ablation with Dedicated Cool-Tip Radiofrequency System can induce complete tumor necrosis in small invasive breast carcinomas irrespective of the glandular pattern of the breast, accordings to the findings of a study published in 'Radiology'.

In this study Guglielmo Manenti, MD and colleagues evaluated the efficacy of a newly developed breast radiofrequency (RF) ablation system in human small invasive breast carcinomas in terms of induction of complete tumor necrosis, reproducibility of ablation lesion size and shape, and cosmetic outcome.

Thirty-four postmenopausal women with biopsy-proved invasive ductal breast carcinomas were included in the study. They were divided into three groups based on the glandular pattern of their breasts as shown by mammography findings. RF energy was delivered to the tumor through a 25-mm 15-gauge monopolar cool-tip needle electrode. The lumens of the needle electrode had connectors for flow of chilled saline solution to permit continuous internal cooling. A peristaltic pump cooled the electrode internally by delivering a chilled saline perfusion through its cannula sheath, providing cooling of the electrode tip. Breast was elevated and gentle breast compressions was was done throughout the procedure by elevating the breast to avoid any lesion shift and to increase the distance between the target lesion and chest wall. All the subjects underwent surgery 4weeks later.

Detailed histopathological analysis was done post procedure. The volume of the ablated zone wasy calculated using the formula: Tumor volume (mm3) = π × largest diameter (mm) × [smallest diameter (mm) × 2/6]. The ablation time was also noted. The residual tumor was detected and compared with tumor seen on the preablation biopsy, by using hematoxylin-eosin staining. And the tissue response to radiofrequency ablation was noted and graded. NADH-diaphorase Cell Viability Analysis was done since it permits evaluation of cell viability based on enzymatic activity rather than cellular architecture. Because the activity of NADH-diaphorase subsides immediately on cell damage, the activity of the compound was evaluated on frozen tissue sections. Histopathologic data were compared with postprocedural 3.0-T contrast material–enhanced magnetic resonance (MR) images.
Cosmesis after RF ablation was assessed.

For 97% of Percutaneous US-guided Radiofrequency Ablation with Dedicated Cool-Tip Radiofrequency, nicotinamide adenine dinucleotide in its reduced form–diaphorase staining showed no evidence of viable cells, thus proving that it can cause complete tumor necrosis. The mean induced ablation volume, as assessed with histologic analysis, was 12.50 cm3 ± 0.8. Tumor ablation volume on the postablation MR images were consistent with histological findings, thus emerging as a useful tool in follow-up post procedure The ablation time and volume were independent of the glandular pattern of the breast. The shape of the induced necrosis was like a sphere in all cases and the cosmesis was excellent in 28 patients.

Source: 'Radiology' Journal