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Focused Microwave Phased Array Thermotherapy for Ablation of Early-Stage Breast Cancer: Results of Thermal Dose Escalation

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Abstract

Background: Tumor ablation as a means of treating breast cancer is being investigated. Microwave energy is promising because it can preferentially heat high-water-content breast carcinomas, compared to adipose and glandular tissues.

Methods: This is a prospective, multicenter, nonrandomized dose-escalation study of microwave treatment. Thermal dose was measured as (1) thermal equivalent minutes (cumulative equivalent minutes; CEM) of treatment relative to a temperature of 43°C and (2) peak tumor temperature. Microwaves were guided by an antenna-temperature sensor placed percutaneously into the tumor. Outcomes measured were pathologic response (tumor necrosis) side effects.

Results: Twenty-five patients (mean age, 57 years) were enrolled. The mean tumor diameter was 1.8 cm. Tumoricidal temperatures (>43°C) were reached in 23 patients (92%). Tumor size was unchanged after thermotherapy (P = not significant). Pathologic necrosis was achieved in 17 (68%) patients. Complete necrosis of the invasive component was achieved in two patients. One hundred forty CEM is predictive of a 50% tumor response, and 210 CEM is predictive of a 100% tumor response (P = .003). Univariate linear regression predicts that peak tumor temperatures of 47.4°C and 49.7°C cause a 50% tumor response and a 100% tumor response, respectively.

Conclusions: Thermotherapy causes tumor necrosis and can be performed safely with minimal morbidity. The degree of tumor necrosis is a function of the thermal dose. Future studies will evaluate the impact of high doses of thermotherapy on margin status and complete tumor ablation.

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Authors and Affiliations

  1. Harbor-UCLA Medical Center, Torrance, California

    Hernan I. Vargas MD, Katherine D. Gonzalez RN & Rose Venegas MD

  2. The University of Oklahoma, Health Sciences Center, Oklahoma City, Oklahoma

    William C. Dooley MD

  3. Columbia Hospital, West Palm Beach, Florida

    Robert A. Gardner MD

  4. Martin-Luther University, Halle, Germany

    Sylvia H. Heywang-Kobrunner MD

  5. Massachusetts Institute of Technology, Lexington, Massachusetts

    Alan J. Fenn PhD

  6. Division of Surgical Oncology, Harbor-UCLA Medical Center, 1000 W. Carson Street, Torrance, CA, 90509

    Hernan I. Vargas MD

Authors
  1. Hernan I. Vargas MD
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  2. William C. Dooley MD
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  3. Robert A. Gardner MD
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  4. Katherine D. Gonzalez RN
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  5. Rose Venegas MD
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  6. Sylvia H. Heywang-Kobrunner MD
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  7. Alan J. Fenn PhD
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Corresponding author

Correspondence to Hernan I. Vargas MD.

Additional information

Presented at the 2003 Society of Surgical Oncology Cancer Symposium, Los Angeles, California, March, 5–9, 2003.

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Vargas, H.I., Dooley, W.C., Gardner, R.A. et al. Focused Microwave Phased Array Thermotherapy for Ablation of Early-Stage Breast Cancer: Results of Thermal Dose Escalation. Ann Surg Oncol 11, 139–146 (2004). https://doi.org/10.1245/ASO.2004.03.059

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  • DOI: https://doi.org/10.1245/ASO.2004.03.059

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