Microwave Ablation Alternative to Surgery for T2 Breast Tumors

The study covered in this summary was published on researchsquare.com as a preprint and has not yet been peer reviewed.

Key Takeaway

  • The recent findings revealed no statistically significant difference in 3-year disease-free survival (DFS) between women who underwent microwave ablation and women who underwent conventional breast-conserving surgery for T2 primary invasive breast cancers.

Why This Matters

  • Breast-conserving surgery is the standard option for early-stage breast cancer.

  • Several studies have shown that microwave ablation is an alternative for patients with T1 tumors (≤2 cm), particularly for women who are not candidates for surgery or who are looking for optimal cosmetic results.

  • The study suggests that microwave ablation may also be a good alternative for patients with T2 (>2 to 5 cm) breast cancers.

Study Design

  • The team used propensity scoring to match and compare prognoses, complications, and cosmetic results for 32 women who underwent microwave ablation to treat 2- to 5-cm breast cancers with outcomes for 56 women who underwent standard breast-conserving surgery.

  • Microwave ablation was offered to women who were poor surgical candidates or were reluctant to undergo surgery.

  • Patients had well-defined primary invasive T2N0–1M0 tumors.

  • For the patients who underwent microwave ablation, complete ablation of tumor was defined as an ablative margin of ≥5 mm of healthy breast tissue. Positive lymph nodes were also ablated.

  • There was no statistically significant difference in the proportion of women in each arm who received adjuvant chemotherapy, endocrine therapy, or radiotherapy.

  • Median follow-up was 33 months.

Key Results

  • Three-year DFS was 94.7% in the microwave ablation group, vs 97.8% with breast-conserving therapy (P = .325).

  • Three-year local tumor progression was achieved in 4.15% with microwave ablation and in 2.85% with breast-conserving therapy (P = .841).

  • Statistically comparable DFS and local tumor progression were also seen in separate analyses of 2–3 cm and 3–5 cm tumors.

  • Nine surgical patients (16.1%) but no microwave ablation patients developed upper limb lymphedema; three patients in the microwave ablation group (9.4%) and 22 (39.3%) patients in the surgical group developed chronic breast/axilla pain after their procedures.

  • Overall, microwave ablation was associated with shorter operative times, less blood loss, lower postoperative complication rates, and better cosmetic results, but it cost more, owing to multidisciplinary consultations and comprehensive evaluation before the procedure.

Limitations

  • It was a retrospective study with a relatively small number of patients.

  • Ablation was performed at two tertiary centers that had extensive experience in the technique, which limits the ability to generalize the results to other settings.

Disclosures

  • The study was funded by the National Scientific Foundation Committee of China.

  • The investigators did not report any relevant financial relationships.

This is a summary of a preprint research study, “Percutaneous Microwave Ablation Versus Breast Conserving Surgery for 2–5 cm Breast Cancer: A Two-Center, Retrospective Study,” led by Yu-qing Dai of the 5th Medical Center of Chinese PLA General Hospital, Beijing, provided to you by Medscape. The study has not been peer reviewed. The full text can be found on researchsquare.com.

M. Alexander Otto is a physician assistant with a master’s degree in medical science and a journalism degree from Newhouse. He is an award-winning medical journalist who has worked for several major news outlets before joining Medscape and also an MIT Knight Science Journalism fellow. Email: [email protected].

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