Precision Breast-Conserving Surgery With Microwave Ablation Guidance: A Pilot Single-Center, Prospective Cohort...

Area of Science:

• Oncology
• Surgical Oncology
• Medical Imaging

Background:

• Achieving negative margins in breast-conserving surgery (BCS) is critical for preventing cancer recurrence.
• Early-stage breast cancer management often involves BCS to preserve breast tissue.
• The effectiveness of preoperative techniques in improving BCS outcomes requires further investigation.

Purpose of the Study:

• To evaluate the utility of preoperative microwave ablation (MWA) in guiding BCS for early-stage breast cancer.
• To determine if MWA influences the rates of positive resection margins during BCS.
• To assess the impact of MWA on the accuracy of BCS and sentinel lymph node biopsy (SLNB).

Main Methods:

• A prospective study involving 22 women with T1/T2 invasive breast cancer from 2016-2018.
• Ultrasound-guided MWA performed under local anesthesia, followed by BCS and SLNB one week later.
• Comparison with a control group undergoing palpation-guided BCS, using propensity score matching analysis.

Main Results:

• MWA guidance group showed a significantly lower rate of positive/close margins compared to the control group (P=0.018).
• MWA resulted in a higher rate of accurate surgery, defined by margin size (P=0.042).
• Sentinel lymph nodes were successfully identified in all eligible MWA cases, with no recurrence observed during a mean follow-up of 23 months.

Conclusions:

• Preoperative MWA can accurately guide BCS for T1/T2 breast cancer.
• MWA does not appear to impair the success of sentinel lymph node biopsy.
• Further clinical trials are needed to validate MWA for breast cancer excision guidance with long-term follow-up.