Ablative options advance breast cancer treatment.(Gynecology)

FORT LAUDERDALE, FLA. -- Ablation is playing an increasingly important role in the treatment of breast cancers, according to experts at the annual meeting of the American College of Surgeons.

Ablation-assisted lumpectomy techniques, including radiofrequency ablation-assisted lumpectomy and cryoassisted lumpectomy, which were designed to reduce the need for reexcision after breast tumor removal, are showing promise for improving outcomes in breast cancer patients.

Percutaneous laser ablation, which targets the tumors themselves, is also showing promise.

As tumors are detected earlier and at smaller sizes, surgical precision becomes more of a challenge, said Lorraine Tafra, M.D., who is the director of the breast center at Anne Arundel Medical Center, Annapolis, Md.

She added that conventional techniques may remove more tissue than necessary, leaving patients with excessive scarring, pain, and loss of tissue volume. Ablative techniques are being explored to provide more precision and reduce the need for additional surgical procedures to clear margins.

Lumpectomy assisted with radiofrequency ablation (RFA) involves the use of heat to sear a 1-cm margin around a tumor that has been excised. The goal is to reduce the risk of tumor recurrence and, thus, the need for repeat lumpectomy and/or radiation therapy, said Suzanne Klimberg, M.D., director of the division of breast surgical oncology at the University of Arkansas, Little Rock.

In an ongoing pilot study, 26 patients have undergone the procedure, which is followed by intraoperative immunofluorescence to ensure no residual live cells remain in the ablation zone. Of seven patients with positive margins who were successfully ablated, six most likely would have required reexcision had they undergone standard needle localization and lumpectomy, Dr. Klimberg noted.