Focused Microwave Thermotherapy for Preoperative Treatment of Invasive Breast Cancer: A Review of Clinical Studies
- 22 December 2009
- journal article
- research article
- Published by Springer Science and Business Media LLC in Annals of Surgical Oncology
- Vol. 17 (4), 1076-1093
- https://doi.org/10.1245/s10434-009-0872-z
Abstract
Background Preoperative focused microwave thermotherapy (FMT) is a promising method for targeted treatment of breast cancer cells. Results of four multi-institutional clinical studies of preoperative FMT for treating invasive carcinomas in the intact breast are reviewed. Methods Externally applied wide-field adaptive phased-array FMT has been investigated both as a preoperative heat-alone ablation treatment and as a combination treatment with preoperative anthracycline-based chemotherapy for breast tumors ranging in ultrasound-measured size from 0.8 to 7.8 cm. Results In phase I, eight of ten (80%) patients receiving a single low dose of FMT prior to receiving mastectomy had a partial tumor response quantified by either ultrasound measurements of tumor volume reduction or by pathologic cell kill. In phase II, the FMT thermal dose was increased to establish a threshold dose to induce 100% pathologic tumor cell kill for invasive carcinomas prior to breast-conserving surgery (BCS). In a randomized study for patients with early-stage invasive breast cancer, of those patients receiving preoperative FMT at ablative temperatures, 0 of 34 (0%) patients had positive tumor margins, whereas positive margins occurred in 4 of 41 (9.8%) of patients receiving BCS alone (P = 0.13). In a randomized study for patients with large tumors, based on ultrasound measurements the median tumor volume reduction was 88.4% (n = 14) for patients receiving FMT and neoadjuvant chemotherapy, compared with 58.8% (n = 10) reduction in the neoadjuvant chemotherapy-alone arm (P = 0.048). Conclusions Wide-field adaptive phased-array FMT can be safely administered in a preoperative setting, and data from randomized studies suggest both a reduction in positive tumor margins as a heat-alone treatment for early-stage breast cancer and a reduction in tumor volume when used in combination with anthracycline-based chemotherapy for patients with large breast cancer tumors. Larger randomized studies are required to verify these conclusions.Keywords
This publication has 55 references indexed in Scilit:
- A large-scale study of the ultrawideband microwave dielectric properties of normal, benign and malignant breast tissues obtained from cancer surgeriesPhysics in Medicine & Biology, 2007
- A large-scale study of the ultrawideband microwave dielectric properties of normal breast tissue obtained from reduction surgeriesPhysics in Medicine & Biology, 2007
- Extracorporeal high intensity focused ultrasound treatment for patients with breast cancerBreast Cancer Research and Treatment, 2005
- Chemotherapy: What Progress in the Last 5 Years?Journal of Clinical Oncology, 2005
- Advances in Breast Conservation TherapyJournal of Clinical Oncology, 2005
- Laser Therapy of Breast Cancer with 3-Year Follow-upThe Breast Journal, 2004
- Cryoablation of Early-Stage Breast Cancer: Work-in-Progress Report of a Multi-Institutional TrialAnnals of Surgical Oncology, 2004
- Hyperthermia in oncologyInternational Journal of Hyperthermia, 2001
- An adaptive microwave phased array for targeted heating of deep tumours in intact breast: animal study resultsInternational Journal of Hyperthermia, 1999
- The Sequencing of Chemotherapy and Radiation Therapy after Conservative Surgery for Early-Stage Breast CancerThe New England Journal of Medicine, 1996