According to a new study, ablating tumors with sound waves may become one effective way to treat breast cancer.
In a small study comprising of 12 patients, 10 had successful tumor ablation with magnetic resonance (MR)-guided focused ultrasound,Alessandro Napoli, MD, PhD, of Sapienza University in Rome, and peers reported at the annual meeting of the Radiological Society of North America (RSNA).
“But two of those patients had residual tumor left after the procedure, due to a transducer malfunction,” mentioned Napoli.
"This procedure allows for safe ablation of breast cancer. At pathology, no significant viable tumor was found in the specimens from these 10 patients,” he said.
Salomao Faintuch, MD, of Beth Israel Deaconess Medical Center, who wasn't directly involved in the study, but commented on the results, calling them interesting, but was aware that the work was still at an early stage.
"This is very new technology, and we're dealing with a disease that's deadly. Before we use this technology as a sole method of treatment, we definitely need to have a lot more results,” he said.
The new method utilizes focused ultrasound waves on a particular point to wipe out tissue, and is effectively heat ablation. It's directed by magnetic resonance imaging, which allows for monitoring not only the location of the targeted tissue, but also the temperature of that tissue.
Napoli and peers performed their safety and practicability study in 12 women who were diagnosed with invasive breast cancer. All of them had stage I disease with a lesion that was less than 2 cm in diameter.
All women had been scheduled for a lumpectomy and a sentinel lymph node biopsy, and each ablation process was followed by surgery in order to verify how well the treatment worked.
“There were no significant complications during or after the procedure, and it was successful in 10 of the 12 patients as revealed by surgical pathology following the ablation therapy. In the other two cases, treatment failed due to a transducer malfunction, they reported, and a pathologist observed some residual tumor,” said Napoli.
Napoli also mentioned just how long the ablation procedure is, taking up 2.5 hours in some cases. "It's a long time being on the table of the MR unit," he said, but he expects that it is likely to speed up in the future, since the technology is still hasn’t matured.
He noted that patients "like the idea that they can have their cancer removed without being cut open. But it is hard to procure those patients. These patients belong to the surgery community, but we are in the radiological setting, so they are just passing by to us.”
Faintuch concurred that it would be hard to change the established, proven method of treatment for breast cancer: "The mainstay of treatment is surgery, combined with additional treatments such as hormonal therapy, chemotherapy or radiation therapy. It won't be widely used until we have enough research to show this new modality has outcomes that are equivalent [to that standard],” he said.
He added that physicians in Japan have been applying the technology more frequently, which may add to the small, but growing body of data available on the procedure.
"We look forward to more results from the Italian researchers, as well as the Japanese researchers, to move [this technology] on to next level," Faintuch concluded.
