A new technique known as radio frequency (RF) ablation can successfully treat small breast cancer with radio frequency radiation by heating and destroying the cancer. Radio frequency ablation is being tested as a less invasive means of destroying various solid tumours. Researchers from the University of Texas M. D. Anderson Cancer Centre in Houston conducted a study to treat breast tumours of 2 cm or less in diameter. The clinicians used real-time ultrasound guidance to place the umbrella-like prongs of the RF electrode around the tumour, and then maintained a temperature of 95 degrees Centigrade for 15 minutes. Twenty women in the study underwent mastectomy immediately afterwards. On examination, the resected tissue showed complete loss of viability of the tumour cells. In one patient who had undergone chemotherapy prior to surgery, however, microscopic examination showed residual areas of viable cancer surrounding the ablated lesion that could not be seen on sonograms or mammograms. Therefore, the researchers no longer perform RF ablation that relies on the ultrasound visualization of tumours in patients who have undergone preoperative chemotherapy. They also advise against using RF ablation for tumours likely to harbour microscopic disease extension. The team recommends multiple needle biopsies and assessment of lymph nodes about a month after the procedure to confirm successful destruction of the entire cancer. The degree of long-term tumour control also needs to be determined.

Radiology,
March 2004
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