摘要
<strong>Objective: </strong><span style="font-family:""><span style="font-family:Verdana;">This study aimed to evaluate the feasibility, safety, and cosmetic outcomes of percutaneous cryoablation (PCA) of breast intraductal carcinoma (IDC) lesions, as well as post-cryoablation magnetic resonance imaging (MRI) as a follow-up tool for detection of residual malignancies and local recurren</span><span><span style="font-family:Verdana;">ces. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">Eight female patients underwent percutaneous ultrasound-</span></span><span style="font-family:Verdana;">guided cryoablation of breast IDC tumors under local anesthesia without subsequent resectio</span><span style="font-family:Verdana;">n. All patients received radiation- and endocrine therapies (RT, ET). The patients were followed using vacuum-assisted biopsy (VAB), mammography (MG), magnetic resonance imaging (MRI), and Moiré Topography for cosmetic outcomes. VAB was performed 6 months following cryoablation treatment for cases 1 and 2 (after starting radiation- and endocrine-therapies) or one month after PCA (cases 3, 4, 5, 6 and 7), prior to RT and ET. One patient declined VAB. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">Mean age of the patients was 61.9 years, SD 7.7, ages range 53 - 72 years. Mean tumor size was 10.3 mm, SD 2.74, ranged 6.8 - 14.5 mm, median follow-up time was 28 months (range 13 - 34 months). No residual or recurrent malignancies were detected. </span><span style="font-family:Verdana;">One minor adverse event was observed: A skin redness in the ablated area;MRI at one-month post-cryotherapy showed various degrees of thermal burns in all patients in the pectoralis major muscle, which were not symptomatic and were resolved by 6 months following PCA. Decrease of fat necrosis areas in the vicinity of ablated ex-tumor was traced with MRI (mean size 54.9 mm, mean decrease after 2 years was 58%) and validated with VAB. </span><b><span style="font-family:Verdana;">Conclusions:</span></b><span style="font-family:Verdana;"> Per</span><span style="font-family:Verdana;">cutaneous cryoablation of early-stage low-risk breast cancer tumors smaller than 15 mm potentially presents a potential substitute for lumpectomy, o</span><span style="font-family:Verdana;">ffering encouraging short- to mid-term oncology results with good cosmesis outcomes. Patients would be able to benefit from local anesthesia in an outpatient setting and a shorter recovery period.</span></span>
<strong>Objective: </strong><span style="font-family:""><span style="font-family:Verdana;">This study aimed to evaluate the feasibility, safety, and cosmetic outcomes of percutaneous cryoablation (PCA) of breast intraductal carcinoma (IDC) lesions, as well as post-cryoablation magnetic resonance imaging (MRI) as a follow-up tool for detection of residual malignancies and local recurren</span><span><span style="font-family:Verdana;">ces. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">Eight female patients underwent percutaneous ultrasound-</span></span><span style="font-family:Verdana;">guided cryoablation of breast IDC tumors under local anesthesia without subsequent resectio</span><span style="font-family:Verdana;">n. All patients received radiation- and endocrine therapies (RT, ET). The patients were followed using vacuum-assisted biopsy (VAB), mammography (MG), magnetic resonance imaging (MRI), and Moiré Topography for cosmetic outcomes. VAB was performed 6 months following cryoablation treatment for cases 1 and 2 (after starting radiation- and endocrine-therapies) or one month after PCA (cases 3, 4, 5, 6 and 7), prior to RT and ET. One patient declined VAB. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">Mean age of the patients was 61.9 years, SD 7.7, ages range 53 - 72 years. Mean tumor size was 10.3 mm, SD 2.74, ranged 6.8 - 14.5 mm, median follow-up time was 28 months (range 13 - 34 months). No residual or recurrent malignancies were detected. </span><span style="font-family:Verdana;">One minor adverse event was observed: A skin redness in the ablated area;MRI at one-month post-cryotherapy showed various degrees of thermal burns in all patients in the pectoralis major muscle, which were not symptomatic and were resolved by 6 months following PCA. Decrease of fat necrosis areas in the vicinity of ablated ex-tumor was traced with MRI (mean size 54.9 mm, mean decrease after 2 years was 58%) and validated with VAB. </span><b><span style="font-family:Verdana;">Conclusions:</span></b><span style="font-family:Verdana;"> Per</span><span style="font-family:Verdana;">cutaneous cryoablation of early-stage low-risk breast cancer tumors smaller than 15 mm potentially presents a potential substitute for lumpectomy, o</span><span style="font-family:Verdana;">ffering encouraging short- to mid-term oncology results with good cosmesis outcomes. Patients would be able to benefit from local anesthesia in an outpatient setting and a shorter recovery period.</span></span>
作者
Hisanori Kawamoto
Koichiro Tsugawa
Mariko Takishita
Mizuho Tazo
Mari Hara Nakano
Tomoko Tsuruga
Ryoko Oi
Takako Kuroda
Reiko Yoshie
Ayaka Shimo
Tsuguo Iwatani
Arata Shimo
Yasuyuki Kojima
Ai Motoyoshi
Ei Haku
Yukari Yabuki
Akihiko Suto
Yoshihide Kanemaki
Hidefumi Mimura
Ichiro Maeda
Mamoru Fukuda
Hisanori Kawamoto;Koichiro Tsugawa;Mariko Takishita;Mizuho Tazo;Mari Hara Nakano;Tomoko Tsuruga;Ryoko Oi;Takako Kuroda;Reiko Yoshie;Ayaka Shimo;Tsuguo Iwatani;Arata Shimo;Yasuyuki Kojima;Ai Motoyoshi;Ei Haku;Yukari Yabuki;Akihiko Suto;Yoshihide Kanemaki;Hidefumi Mimura;Ichiro Maeda;Mamoru Fukuda(Department of Breast Surgery Breast and Imaging Center, St. Marianna University School of Medicine, Kawasaki-Shi, Japan;Division of Breast and Endocrine Surgery, Department of Surgery, St. Marianna University School of Medicine, Kawasaki-Shi, Japan;Department of Radiology, St. Marianna University School of Medicine, Kawasaki-Shi, Japan;Department of Pathology, St. Marianna University School of Medicine, Kawasaki-Shi, Japan)