Elderly with Breast Cancer Could Be Spared from Surgery

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(ChemotherapyAdvisor) – Elderly patients with nonresected breast cancer could be spared from surgery due to the effectiveness of ultrasonography (US)–guided percutaneous radiofrequency (RF) ablation, according to a team of French researchers. This conclusion is based on an article entitled “Radiofrequency Ablation as a Substitute for Surgery in Elderly Patients with Nonresected Breast Cancer: Pilot Study with Long-term Outcomes,” which is published in the August issue of Radiology.

In this study, the investigators aimed to determine “the efficacy and tolerance of ultrasonography (US)–guided percutaneous radiofrequency (RF) ablation with endocrine therapy in elderly patients with breast cancer who decline or are not candidates for surgery.”

To meet this aim, patients who met the following eligibility criteria were recruited: age >70 years, diagnosis of breast carcinoma, treatment with neoadjuvant endocrine therapy within the past 6 months, tumors size ≤ 3 cm; these patients underwent US-guided RF ablation under local anesthesia and sedation. Patients (N = 21) were then monitored for up to 5 years, with US, mammography, and dynamic contrast material–enhanced (DCE) magnetic resonance (MR) imaging being performed every 2 months for the first 6 months and then every 6 months until the end of the study. End points were RF ablation efficacy at 1 year and delayed local efficacy at 5 years (the end of endocrine therapy).

The investigators reported that the effectiveness of this treatment regimen, as measured by RF ablation efficacy, was demonstrated at 1 year, with local relapse occurring in 1 patient. The treatment was also generally well-tolerated with the only adverse event being skin burn (n = 4). “Ten patients were followed up for 5 years, with 3 additional patients presenting with cancer recurrence outside the ablation zone at 30, 48, and 60 months—including 2 with lobular carcinoma,” they reported. “Four patients died during the full follow-up, 2 of breast cancer–related causes and two of unrelated causes.”

Although the investigators concluded that RF ablation in elderly patients with nonresected breast cancer is well tolerated and efficient at 1-year follow-up, they recommended that the technique not be used for patients with lobular carcinoma.



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