ABSTRACT
PURPOSE: To assess the feasibility and effectiveness of radiofrequency ablation (RFA) in breast cancer, using different histopathologic staining methods to evaluate tissue viability. MATERIALS AND METHODS: In twenty patients with unifocal small (≤1, 5 cm) invasive ductal carcinoma, ultrasound-guided RFA was performed immediately after surgery. Cell viability was assessed using cytokeratin 8 (CK 8) and nicotinamide adenine dinucleotide diaphorase (NADHD) in addition to hematoxylin-eosin (HE). RESULTS: At histopathological examination, ex vivo RFA resulted in complete cell death of the target lesion in 17/20 patients. In two cases viable ductal carcinoma in situ (DCIS) was found just outside the completely ablated lesion. CONCLUSION: RFA of small invasive breast cancer seems to be a feasible treatment option. Both NADHD and CK 8 demonstrate a clear and comparable demarcation between viable and non-viable tissue. A high level of accuracy is required in proper positioning of the needle electrode and a "hot retraction" is mandatory.
Subject(s)
Breast Neoplasms/surgery , Carcinoma, Ductal, Breast/surgery , Catheter Ablation/methods , Surgery, Computer-Assisted/methods , Ultrasonography, Mammary/methods , Aged , Breast Neoplasms/pathology , Carcinoma, Ductal, Breast/pathology , Carcinoma, Intraductal, Noninfiltrating/pathology , Carcinoma, Intraductal, Noninfiltrating/surgery , Cell Survival , Feasibility Studies , Female , Humans , In Vitro Techniques , Mastectomy , Mastectomy, Segmental , Middle Aged , Treatment Outcome , Ultrasonography, Interventional/methodsSubject(s)
Aneurysm/diagnostic imaging , Aortic Aneurysm, Thoracic/diagnostic imaging , Cardiovascular Abnormalities/diagnostic imaging , Deglutition Disorders/diagnostic imaging , Aged , Aneurysm/complications , Aorta, Thoracic/diagnostic imaging , Aortic Aneurysm, Thoracic/complications , Cardiovascular Abnormalities/complications , Contrast Media , Deglutition Disorders/complications , Diagnosis, Differential , Female , Humans , Imaging, Three-Dimensional/methods , Radiographic Image Enhancement/methods , Subclavian Artery/abnormalities , Subclavian Artery/diagnostic imaging , Tomography, X-Ray Computed/methodsABSTRACT
Breast cancer is an important health care problem, especially in the increasing elderly generation. Treatment of these fragile patients is a challenge for the clinician. Undertreatment has been linked to a higher percentage of recurrence and cancer related morbidity, while overtreatment leads to treatment related morbidity and mortality. Minimally invasive techniques do offer new opportunities for patients, who are no candidates for conventional surgery. The tumor lesion is treated locally and selective with minimal damage to surrounding tissue, yielding an adequate local tumor control. Radio frequency ablation technique seems an effective and safe method for treatment of the elderly patient with small (< 3 cm) breast cancer.
Subject(s)
Breast Neoplasms/surgery , Catheter Ablation/methods , Minimally Invasive Surgical Procedures , Aged , Aged, 80 and over , Breast Neoplasms/mortality , Female , Humans , Treatment OutcomeABSTRACT
Two patients with splenic bleeding were treated with transcatheter embolisation and selective coiling of the splenic artery. These were first of all a 78-year-old woman who was on anticoagulants for atrial fibrillation and suffered a laceration of the spleen with extravasation of contrast medium and a falling haemoglobin level. The second patient was a 23-year-old woman who suffered laceration of the spleen as the result of a traffic accident. Embolisation made it possible to avoid surgical treatment and preserve the spleen in both patients. Selective embolisation of the splenic artery is a useful adjunct to the non-operative management of patients with traumatic splenic injury. However, the proper patient selection still needs to be established.
