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Extracorporeal high intensity focused ultrasound treatment for patients with breast cancer

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Abstract

Purpose. To investigate the safety, efficacy and feasibility of using high-intensity focused ultrasound (HIFU) as a non-invasive treatment for patients with breast cancer.

Patients and Methods. Twenty-two patients with breast cancer were enrolled into this non-randomized prospective trial. Disease TNM stage was classified as stage I in 4 patients, stage IIA in 9 patients, stage IIB in 8 patients, and stage IV in 1 patient. Tumor size ranged from 2 to 4.8 cm in diameter (mean 3.4 cm). All patients received chemotherapy, radiation and tamoxifen, following HIFU for the primary lesions. Outcome measures included radiological and pathologic assessment of the treated tumor, cosmesis, and local recurrence. A cumulative survival rate is calculated by using the Kaplan–Meier method.

Results. No severe complications were encountered after HIFU. Post-operative imaging demonstrated positive response and regression of all treated lesions. Follow-up biopsy revealed coagulation necrosis of target tumor and subsequent replacement by fibroblastic tissue. After a median follow-up of 54.8 months, 1 patient died, 1 was lost to follow-up, and 20 were still alive. Two of 22 patients developed local recurrence. Five-year disease-free survival and recurrence-free survival were 95% and 89%, respectively. Cosmetic result was judged as good to excellent in 94% of patients.

Conclusions. HIFU treatment is safe, effective, and feasible for patients with breast cancer. But, large-scale, multiple-center clinical trials will be needed to determine the future role of this novel modality.

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References

  1. JE Kennedy GR ter Haar D. Cranston (2003) ArticleTitleHigh intensity focused ultrasound: surgery of the future? Br J Radiol 76 590–599 Occurrence Handle10.1259/bjr/17150274 Occurrence Handle1:STN:280:DC%2BD3svjvFKrsA%3D%3D Occurrence Handle14500272

    Article  CAS  PubMed  Google Scholar 

  2. GR. ter Haar (2001) ArticleTitleHigh intensity ultrasound Semin Laparosc Surg. 8 77–89 Occurrence Handle10.1053/slas.2001.24402 Occurrence Handle1:STN:280:DC%2BD3Mzps1answ%3D%3D Occurrence Handle11337740

    Article  CAS  PubMed  Google Scholar 

  3. F Wu ZB Wang YD Cao WZ Chen J Bai JZ Zou H. Zhu (2003) ArticleTitleA randomised clinical trial of high-intensity focused ultrasound ablation for the treatment of patients with localized breast cancer Br J Cancer 89 2227–2233 Occurrence Handle10.1038/sj.bjc.6601411 Occurrence Handle1:STN:280:DC%2BD3srptlyntw%3D%3D Occurrence Handle14676799

    Article  CAS  PubMed  Google Scholar 

  4. F Wu ZB Wang YD Cao WZ Chen JZ Zou J Bai H Zhu KQ Li CB Jin FL Xie HB Su GW. Gao (2000) ArticleTitleChanges in biologic characteristics of breast cancer treated with high-intensity focused ultrasound Ultrasound Med Biol 29 1487–1492 Occurrence Handle10.1016/S0301-5629(03)01034-2

    Article  Google Scholar 

  5. JE Kennedy F Wu GR ter Haar FV Gleeson RR Phillips MR Middleton D. Cranston (2004) ArticleTitleHigh-intensity focused ultrasound for the treatment of liver tumors Ultrasonics 42 931–935 Occurrence Handle1:STN:280:DC%2BD2c7lsFOhsg%3D%3D Occurrence Handle15047409

    CAS  PubMed  Google Scholar 

  6. F Wu WZ Chen J Bai JZ Zou ZL Wang H Zhu ZB. Wang (2001) ArticleTitlePathological changes in human malignant carcinoma treated with high-intensity focused ultrasound Ultrasound Med Biol 27 1099–1106 Occurrence Handle10.1016/S0301-5629(01)00389-1 Occurrence Handle1:STN:280:DC%2BD3Mvos1anuw%3D%3D Occurrence Handle11527596

    Article  CAS  PubMed  Google Scholar 

  7. F Wu WZ Chen J Bai JZ Zou ZL Wang H Zhu ZB. Wang (2002) ArticleTitleTumor vessel destruction resulting from high-intensity focused ultrasound in patients with solid malignancies Ultrasound Med Biol 28 535–542 Occurrence Handle10.1016/S0301-5629(01)00515-4 Occurrence Handle12049967

    Article  PubMed  Google Scholar 

  8. F Wu ZB Wang WZ Chen JZ Zou J Bai H Zhu KQ Li FL Xie CB Jin HB Su GW. Gao (2004) ArticleTitleExtracorporeal focused ultrasound surgery for treatment of human solid carcinomas: early Chinese clinical experience Ultrasound Med Biol 30 245–260 Occurrence Handle10.1016/j.ultrasmedbio.2003.10.010 Occurrence Handle14998677

    Article  PubMed  Google Scholar 

  9. ter Haar GR, Kennedy JE, Wu F. (2004). Physical characterisation of extra-corporeal high intensity focused ultrasound (HIFU) treatments of cancer. Ultrasound Med Biol 30: In Press

  10. D Curran JP Van Dongen NK Aronson G Kiebert IS Fentiman F Mignolet H. Bartelink (1998) ArticleTitleQuality of life of early-stage breast cancer patients treated with radical mastectomy or breast-conserving procedure: results of EORTC trial 10801. The European Organization for Research and Treatment of Cancer (EORTC), Breast Cancer Co-operative Group (BCCG) Eur J Cancer 34 307–314 Occurrence Handle10.1016/S0959-8049(97)00312-2 Occurrence Handle1:STN:280:DyaK1czgsVeqtA%3D%3D Occurrence Handle9640214

    Article  CAS  PubMed  Google Scholar 

  11. B Fisher S Anderson CK Redmond N Wolmark DL Wickerham WM. Cronin (1995) ArticleTitleReanalysis and results after 12 years of follow-up in a randomized clinical trial comparing total mastectomy with lumpectomy with or without lumpectomy with or without irradiation in the treatment of breast cancer N Engl J Med 333 1456–1461 Occurrence Handle10.1056/NEJM199511303332203 Occurrence Handle1:STN:280:BymD2MrgvVU%3D Occurrence Handle7477145

    Article  CAS  PubMed  Google Scholar 

  12. BL Fowble LJ Solin DJ Schultz RL. Goodman (1991) ArticleTitleTen-year results of conservative surgery and irradiation for stage I and II breast cancer Int J Radiat Oncol Biol Phys 21 269–277 Occurrence Handle1:STN:280:By6B1crpt1E%3D Occurrence Handle1648040

    CAS  PubMed  Google Scholar 

  13. JA Jacobson DN Danforth KH Cowan T d’Angelo SM Steinberg L Pierce ME Lippman AS Lichter E Glatstein P. Okunieff (1995) ArticleTitleTen-year results of a comparison of conservation with mastectomy in the treatment of stage I and II breast cancer N Engl J Med 332 907–911 Occurrence Handle10.1056/NEJM199504063321402 Occurrence Handle1:STN:280:ByqC1czgvFU%3D Occurrence Handle7877647

    Article  CAS  PubMed  Google Scholar 

  14. JA Dongen Particlevan H Bartelink IS Fentiman T Lerut F Mignolet G Olthuis E Schueren Particlevan der R Sylvester J Winter K. Zijl Particlevan (1992) ArticleTitleRandomized clinical trial to assess the value of breast cancer. E.O.R.T.C. 10801 trial J Natl Cancer Inst Monogre 11 15–18

    Google Scholar 

  15. U Veronesi A Luini M Del Vecchio M Greco V Galimberti M Merson F Rilke V Sacchini R Saccozzi T. Savio (1993) ArticleTitleRadiotherapy after breast-preserving surgery in women with localized cancer of the breast N Engl J Med 328 1587–1591 Occurrence Handle10.1056/NEJM199306033282202 Occurrence Handle1:STN:280:ByyB2MvkvF0%3D Occurrence Handle8387637

    Article  CAS  PubMed  Google Scholar 

  16. BD Fornage MJ Faroux A. Simatos (1987) ArticleTitleBreast masses US-guided fine-needle aspiration biopsy Radiology 162 409–414 Occurrence Handle1:STN:280:BiiD1M3psl0%3D Occurrence Handle3541029

    CAS  PubMed  Google Scholar 

  17. S O’Neil M Castelli P Gattuso L Kluskens K Madsen G. Aranha (1997) ArticleTitleFine-needle aspiration of 697 palpable breast lesions with histopathologic correlation Surgery 122 824–828 Occurrence Handle10.1016/S0039-6060(97)90093-3 Occurrence Handle1:STN:280:DyaK1c%2FgslGmsA%3D%3D Occurrence Handle9347862

    Article  CAS  PubMed  Google Scholar 

  18. TS Kline LP Joshi HS. Neal (1979) ArticleTitleFine-needle aspiration of the breast Diagnoses and pitfalls. A review of 3545 cases Cancer 44 1458–1564 Occurrence Handle1:STN:280:Bi%2BD2cvlsFY%3D Occurrence Handle40687

    CAS  PubMed  Google Scholar 

  19. LW Norton JR Davis JL Wiens DC Trego GL. Dunnington (1984) ArticleTitleAccuracy of aspiration cytology in detecting breast cancer Surgery 96 806–814 Occurrence Handle1:STN:280:BiqD3MjhsVc%3D Occurrence Handle6484817

    CAS  PubMed  Google Scholar 

  20. RM Ulanow L Galblum JW. Canter (1984) ArticleTitleFine needle aspiration in the diagnosis and management of solid breast lesions Am J Surg 148 653–657 Occurrence Handle10.1016/0002-9610(84)90345-3 Occurrence Handle1:STN:280:BiqD2cvltFM%3D Occurrence Handle6496857

    Article  CAS  PubMed  Google Scholar 

  21. RJ Jackman F Burbank SH Parker 3rd Evans WP MC Lechner TR Richardson I Tocino AB. Wray (1997) ArticleTitleAtypical ductal hyperplasia diagnosed at stereotactic breast biopsy: improved reliability with 14-gauge directional vacuum-assisted stereotactic breast biopsy Radiology 204 485–488 Occurrence Handle1:STN:280:ByiA1c3ltlI%3D Occurrence Handle9240540

    CAS  PubMed  Google Scholar 

  22. KJ Kirshenbaum T Voruganti C Overbeeke MD Kirshenbaum P Patel G Kaplan V Maker C August RP. Cavallino (2003) ArticleTitleStereotactic core needle biopsy of non-palpable breast lesions using a conventional mammography unit with an add-on device Am J Roentgenol 181 527–531

    Google Scholar 

  23. L. Liberman (1999) ArticleTitleAdvanced breast biopsy instrumentation (ABBI): analysis of published experience Am J Roentgerol 172 1413–1416 Occurrence Handle1:STN:280:DyaK1M3kt1SltQ%3D%3D

    CAS  Google Scholar 

  24. SH Parker F Burbank RJ Jackman CJ Aucreman G Cardenosa TM Cink JL Coscia SuffixJr GW Eklund WP Evans Suffix3rd PR. Garver (1994) ArticleTitlePercutaneous large-core breast biopsy: a multi-institutional study Radiology 193 359–364 Occurrence Handle1:STN:280:ByqD283ps10%3D Occurrence Handle7972743

    CAS  PubMed  Google Scholar 

  25. RM Pijnappel A Dalen Particlevan IH Rinkes JG Tweel Particlevan den WP. Mali (1997) ArticleTitleThe diagnostic accuracy of core biopsy in palpable and non-palpable breast lesions Eur J Radiol 24 120–123 Occurrence Handle10.1016/S0720-048X(96)01140-0 Occurrence Handle1:STN:280:ByiB2M7jslU%3D Occurrence Handle9097053

    Article  CAS  PubMed  Google Scholar 

  26. DD Adler RL. Wahl (1995) ArticleTitleNew methods for imaging the breast Techniques, findings, and potential Am J Roentgenol 164 19–30 Occurrence Handle1:STN:280:ByqD1M7hvVA%3D

    CAS  Google Scholar 

  27. PJ Drew LW Turnbull S Chatterjee J Read PJ Carleton JN Fox JR Monson MJ. Kerin (1995) ArticleTitleProspective comparison of standard triple assessment and dynamic magnetic resonance imaging of the breast for the evaluation of symptomatic breast lesions Ann Surg 230 680–685 Occurrence Handle10.1097/00000658-199911000-00010

    Article  Google Scholar 

  28. T Hata H Takahashi K Watanabe M Takahashi K Taguchi T Itoh S. Todo (2004) ArticleTitleMagnetic resonance imaging for preoperative evaluation of breast cancer: a comparative study with mammography and ultrasonography J Am Coll Surg 198 190–197 Occurrence Handle10.1016/j.jamcollsurg.2003.10.008 Occurrence Handle14759774

    Article  PubMed  Google Scholar 

  29. F Podo F Sardanelli R Canese G D’Agnolo PG Natali M Crecco ML Grandinetti R Musumeci G Trecate S. Bergonzi (2002) ArticleTitleThe Italian multi-center project on evaluation of MRI and other imaging modalities in early detection of breast cancer in subjects at high genetic risk J Exp Clin Cancer Res 21 S115–S124

    Google Scholar 

  30. EJ Clifford C. Lugo-Zamudio (1996) ArticleTitleScintimammography in the diagnosis of breast cancer Am J Surg 172 483–486 Occurrence Handle10.1016/S0002-9610(96)00225-5 Occurrence Handle1:STN:280:ByiD1MfgtVw%3D Occurrence Handle8942549

    Article  CAS  PubMed  Google Scholar 

  31. R Danielsson E Reihner A Grabowska B. Bone (2000) ArticleTitleThe role of scintimammography with 99mTc-sestamibi as a complementary diagnostic technique in the detection of breast cancer Acta Radiol 41 441–445 Occurrence Handle10.1080/028418500127345659 Occurrence Handle1:STN:280:DC%2BD3cvmtl2gsQ%3D%3D Occurrence Handle11016763

    Article  CAS  PubMed  Google Scholar 

  32. I Khalkhali JA Cutrone IG Mena LE Diggles RJ Venegas HI Vargas BL Jackson S Khalkhali JF Moss SR. Klein (1995) ArticleTitleScintimammography: the complementary role of Tc-99m sestamibi prone breast imaging for the diagnosis of breast carcinoma Radiology 196 421–426 Occurrence Handle1:STN:280:ByqA2czhtVI%3D Occurrence Handle7617855

    CAS  PubMed  Google Scholar 

  33. S Mekhmandarov J Sandbank M Cohen S Lelcuk E. Lubin (1998) ArticleTitleTechnetium-99m-MIBI scintimammography in palpable and non-palpable breast lesions J Nucl Med 39 86–91 Occurrence Handle1:STN:280:DyaK1c7gtl2kuw%3D%3D Occurrence Handle9443742

    CAS  PubMed  Google Scholar 

  34. B Fisher J Costantino C Redmond E Fisher R Margolese N Dimitrov N Wolmark DL Wickerham M Deutsch L. Ore (1993) ArticleTitleLumpectomy compared with lumpectomy and radiation therapy for the treatment of intraductal breast cancer N Engl J Med 328 1581–1586 Occurrence Handle10.1056/NEJM199306033282201 Occurrence Handle1:STN:280:ByyB2MvkvFw%3D Occurrence Handle8292119

    Article  CAS  PubMed  Google Scholar 

  35. JP Julien N Bijker IS Fentiman JL Peterse V Delledonne P Rouanet A Avril R Sylvester F Mignolet H Bartelink JA. Van Dongen (2000) ArticleTitleRadiotherapy in breast-conserving treatment for ductal carcinoma in situ: first results of the EORTC randomised phase III trial 10853 EORTC Breast Cancer Cooperative Group and EORTC Radiotherapy Group Lancet 355 528–533 Occurrence Handle10.1016/S0140-6736(99)06341-2 Occurrence Handle1:STN:280:DC%2BD3c7ksFajtQ%3D%3D Occurrence Handle10683002

    Article  CAS  PubMed  Google Scholar 

  36. HS. Cody (2001) ArticleTitleClinical aspects of sentinel node biopsy Breast Cancer Res 3 104–108 Occurrence Handle10.1186/bcr280 Occurrence Handle11250755

    Article  PubMed  Google Scholar 

  37. PJ Tanis OE Nieweg RA Valdes Olmos BB. Kroon (2001) ArticleTitleAnatomy and physiology of lymphatic drainage of the breast from the perspective of sentinel node biopsy J Am Coll Surg 192 399–409 Occurrence Handle10.1016/S1072-7515(00)00776-6 Occurrence Handle1:STN:280:DC%2BD3M7osVGgsA%3D%3D Occurrence Handle11245383

    Article  CAS  PubMed  Google Scholar 

  38. HI Vargas WC Dooleyb RA Gardner KD Gonzalez SH Heywang-Kobrunner AJ. Fenne (2003) ArticleTitleSuccess of sentinel lymph node mapping after breast cancer ablation with focused microwave phased array thermotherapy Am J Surgery 186 330–332 Occurrence Handle10.1016/S0002-9610(03)00267-8

    Article  Google Scholar 

  39. PE Huber JW Jenne R Rastert I Simiantonakis HP Sinn HJ Strittmatter D Fournier Particlevon MF Wannenmacher J. Debus (2001) ArticleTitleA new non-invasive approach in breast cancer therapy using magnetic resonance imaging-guided focused US surgery Cancer Res 61 8441–8447 Occurrence Handle1:CAS:528:DC%2BD3MXptFCktb0%3D Occurrence Handle11731425

    CAS  PubMed  Google Scholar 

  40. D Gianfelice A Khiat M Amara A Belblidia Y. Boulanger (2003) ArticleTitleMR imaging-guided focused US ablation of breast cancer: histopathologic assessment of effectiveness - initial experience Radiology 227 849–855 Occurrence Handle12714680

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Institute of Ultrasonic Engineering in Medicine, and Clinical Center for Tumor Therapy of 2nd Hospital, Institute of Ultrasonic Engineering in Medicine, Chongqing University of Medical Sciences, Box 153, 1 Medical College Road, Chongqing, 400016, China

    Feng Wu, Zhi-Biao Wang, Hui Zhu, Wen-Zhi Chen, Jian-Zhong Zou, Jin Bai, Ke-Quan Li, Cheng-Bing Jin, Fang-Lin Xie & Hai-Bing Su

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  1. Feng Wu
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Correspondence to Feng Wu.

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Wu, F., Wang, ZB., Zhu, H. et al. Extracorporeal high intensity focused ultrasound treatment for patients with breast cancer. Breast Cancer Res Treat 92, 51–60 (2005). https://doi.org/10.1007/s10549-004-5778-7

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