Radiofrequency Ablation of Benign Thyroid Nodules and Recurrent Thyroid Cancers: Consensus Statement and Recommendations

Radiofrequency ablation is a new non-surgical treatment modality for patients with benign thyroid nodules and recurrent thyroid cancers. The Task Force Committee of the Korean Society of Thyroid Radiology has developed recommendations for the treatment of benign thyroid nodules and recurrent thyroid cancers using radiofrequency ablation. These recommendations are based on evidence from the current literature and expert consensus.

Radiofrequency Ablation of Benign Thyroid Nodules and Recurrent Thyroid Cancers: Consensus Statement and Recommendations

Thermal ablation using radiofrequency is a new, minimally invasive modality employed as an alternative to surgery in patients with benign thyroid nodules and recurrent thyroid cancers. The Task Force Committee of the Korean Society of Thyroid Radiology has developed recommendations for the optimal use of radiofrequency ablation for thyroid nodules. These recommendations are based on a comprehensive analysis of the current literature, the results of multicenter studies, and expert consensus.

Long-Term Follow-Up Result of Benign Phyllodes Tumor of the Breast Diagnosed and Excised by Ultrasound-Guided Vacuum-Assisted Breast Biopsy / 한국유방암학회지

PURPOSE: Percutaneous removal of benign breast tumors using ultrasound-guided vacuum-assisted breast biopsy (VABB) has been recently regarded as a feasible and safe method without serious complications. The aim of this study was to evaluate the efficacy and safety of the VABB in the treatment of benign phyllodes tumors, and to identify whether or not surgical re-excision is necessary for benign phyllodes tumors diagnosed and excised by VABB. METHODS: From January 2003 to December 2011, a total of 6,923 VABB were performed in 5,434 patients. Out of 6,923 lesions, 53 were benign phyllodes tumors. Among these, 31 lesions, with a follow-up period of longer than 24 months, were enrolled in this study. Ultrasonography follow-up was performed at 3 to 6 month intervals in order to assess recurrence. The mean follow-up period was 75.9+/-13.5 months (range, 24-94 months). RESULTS: The mean patient age at presentation was 31.6+/-9.4 years. The mean size of the lesion was 1.60+/-0.88 cm. The majority of lesions, 74.2% (23 cases), were palpable, and 25.8% (8 cases) were non-palpable. Twenty-two lesions (71.0%) were classified as Breast Imaging Reporting and Data System category 3, and nine lesions (29.0%) were classified as category 4a, by ultrasonography. During the follow-up period, local recurrence developed in one lesion, making the local recurrence rate 3.2%. CONCLUSION: If a benign phyllodes tumor is diagnosed, and sufficiently excised by VABB, observing the clinical course may be considered as an alternative to performing immediate wide local excision; this is the case despite the fact that it would need to be observed for a prolonged period of time.

Is Further Diagnostic Surgery Necessary for the Benign Papillary Lesions that Are Diagnosed by Large Volume Vacuum Assisted Breast Biopsy? / 한국유방암학회지

PURPOSE: There is ongoing controversy regarding the management of papillary lesions that are diagnosed by core needle biopsy (CNB). The development of vacuum assisted biopsy now permits non-operative removal of papillary breast lesions. Our aim was to evaluate whether the papillary lesions diagnosed by vacuum assisted breast biopsy (VABB) can be followed up without further diagnostic excision. METHODS: From January 2003 to July 2009, a total of 4,655 US-guided mammotome excision were performed in 3,714 patients at Kangnam CHA Hospital. Out of 4,655 lesions, 156 lesions were proved to be papillary lesions. Among these, 82 lesions that had histologic findings that were consistent with benign papillary lesions and that were followed up for more than 2 years without further diagnostic surgical excision were collected and retrospectively analyzed. Ultrasonographic follow-up was done at 3-6 month intervals to assess for recurrence. The mean follow up period was 49.6 months. RESULTS: The pathologic diagnoses for the 82 lesions obtained via VABB were benign intraductal papilloma and papillomatosis. Half of the lesions were palpable and 50.0% (41 cases) were nonpalpable. Twenty eight lesions (34.1%) were classified as BIRADS category 3, 50 lesions (61.0%) were category 4A, 3 lesions (3.7%) were category 4B and only 1 lesion (1.2%) was category 5 according to the ultrasound exams. No local recurrence developed during the follow up period that needed surgical re-excision or rebiopsy. None of those diagnosed as benign lesions at VABB were upgraded to a more advanced lesions. CONCLUSION: The benign papillary lesions that are diagnosed and excised by mammotome may not need further diagnostic surgical re-excision if surgeons are sure that the targeted lesions were excised completely.