A Randomised Clinical Trial of High-intensity Focused Ultrasound Ablation for the Treatment of Patients with Localised Breast Cancer

Overview

Journal Br J Cancer

Specialty Oncology

Date 2003 Dec 17

PMID 14676799

Citations 65

Authors

F Wu

Z-B Wang

Y-De Cao

W-Z Chen

J Bai

J-Z Zou

H Zhu

Affiliations

Soon will be listed here.

Abstract

High-intensity focused ultrasound (HIFU) is a noninvasive treatment that induces complete coagulative necrosis of a tumour at depth through the intact skin. This study was to explore the possibility of using HIFU for the treatment of patients with localised breast cancer in a controlled clinical trial. A total of 48 women with biopsy-proven breast cancer (T(1-2), N(0-2), M0) were randomised to the control group in which modified radical mastectomy was performed, and the HIFU group in which an extracorporeal HIFU ablation of breast cancer was followed by modified radical mastectomy. Short-term follow-up, pathologic and immunohistochemical stains were performed to assess the therapeutic effects on tumour and complications of HIFU. The results showed that no severe side effect was observed in the HIFU-treated patients. Pathologic findings revealed that HIFU-treated tumour cells underwent complete coagulative necrosis, and tumour vascular vessels were severely damaged. Immunohistochemical staining showed that no expression of PCNA, MMP-9, and CD44v6 was detected within the treated tumour cells in the HIFU group, indicating that the treated tumour cells lost the abilities of proliferation, invasion, and metastasis. It is concluded that, as a noninvasive therapy, HIFU could be effective, safe, and feasible in the extracorporeal treatment of localised breast cancer.

Citing Articles

Computational predictions of magnetic resonance acoustic radiation force imaging for breast cancer focused ultrasound therapy.

Nelson C, Kline M, Payne A, Dillon C Int J Hyperthermia. 2025; 42(1):2452927.

PMID: 39842813 PMC: 11902895. DOI: 10.1080/02656736.2025.2452927.

Agar-based Phantom for Evaluating Targeting of High-intensity Focused Ultrasound Systems for Breast Ablation.

Filippou A, Damianou C J Med Phys. 2024; 49(3):343-355.

PMID: 39526164 PMC: 11548075. DOI: 10.4103/jmp.jmp_52_24.

Heat application in live cell imaging.

Sistemich L, Ebbinghaus S FEBS Open Bio. 2024; 14(12):1940-1954.

PMID: 39489617 PMC: 11609584. DOI: 10.1002/2211-5463.13912.

Progress in application of nanomedicines for enhancing cancer sono-immunotherapy.

Zhao H, Du F, Xiang X, Tang Y, Feng Z, Wang Z Ultrason Sonochem. 2024; 111:107105.

PMID: 39427436 PMC: 11533716. DOI: 10.1016/j.ultsonch.2024.107105.

A comprehensive numerical procedure for high-intensity focused ultrasound ablation of breast tumour on an anatomically realistic breast phantom.

Rahpeima R, Lin C PLoS One. 2024; 19(10):e0310899.

PMID: 39352893 PMC: 11444401. DOI: 10.1371/journal.pone.0310899.

References

Gelet A, Chapelon J, Bouvier R, Pangaud C, Lasne Y . Local control of prostate cancer by transrectal high intensity focused ultrasound therapy: preliminary results. J Urol. 1999; 161(1):156-62. View

Chapelon J, Ribault M, Vernier F, Souchon R, Gelet A . Treatment of localised prostate cancer with transrectal high intensity focused ultrasound. Eur J Ultrasound. 1999; 9(1):31-8. DOI: 10.1016/s0929-8266(99)00005-1. View

Chen L, Rivens I, Ter Haar G, Riddler S, Hill C, BENSTED J . Histological changes in rat liver tumours treated with high-intensity focused ultrasound. Ultrasound Med Biol. 1993; 19(1):67-74. DOI: 10.1016/0301-5629(93)90019-k. View

Uchida T, Sanghvi N, Gardner T, Koch M, Ishii D, Minei S . Transrectal high-intensity focused ultrasound for treatment of patients with stage T1b-2n0m0 localized prostate cancer: a preliminary report. Urology. 2002; 59(3):394-8; discussion 398-9. DOI: 10.1016/s0090-4295(01)01624-7. View

Beerlage H, Thuroff S, Debruyne F, Chaussy C, de la Rosette J . Transrectal high-intensity focused ultrasound using the Ablatherm device in the treatment of localized prostate carcinoma. Urology. 1999; 54(2):273-7. DOI: 10.1016/s0090-4295(99)00104-1. View

Bohm T, Hilger I, Muller W, Reichenbach J, Fleck M, Kaiser W . Saline-enhanced radiofrequency ablation of breast tissue: an in vitro feasibility study. Invest Radiol. 2000; 35(3):149-57. DOI: 10.1097/00004424-200003000-00001. View

Huber P, Jenne J, Rastert R, Simiantonakis I, Sinn H, Strittmatter H . A new noninvasive approach in breast cancer therapy using magnetic resonance imaging-guided focused ultrasound surgery. Cancer Res. 2001; 61(23):8441-7. View

Jacobson J, DANFORTH D, Cowan K, DAngelo T, Steinberg S, Pierce L . Ten-year results of a comparison of conservation with mastectomy in the treatment of stage I and II breast cancer. N Engl J Med. 1995; 332(14):907-11. DOI: 10.1056/NEJM199504063321402. View

Curran D, van Dongen J, Aaronson N, Kiebert G, Fentiman I, Mignolet F . Quality of life of early-stage breast cancer patients treated with radical mastectomy or breast-conserving procedures: results of EORTC Trial 10801. The European Organization for Research and Treatment of Cancer (EORTC), Breast Cancer Co-operative.... Eur J Cancer. 1998; 34(3):307-14. DOI: 10.1016/s0959-8049(97)00312-2. View

10.

Sibille A, Prat F, Chapelon J, Abou el Fadil F, Henry L, Theilliere Y . Characterization of extracorporeal ablation of normal and tumor-bearing liver tissue by high intensity focused ultrasound. Ultrasound Med Biol. 1993; 19(9):803-13. DOI: 10.1016/0301-5629(93)90096-7. View

11.

Fisher B, Anderson S, Redmond C, Wolmark N, Wickerham D, Cronin W . Reanalysis and results after 12 years of follow-up in a randomized clinical trial comparing total mastectomy with lumpectomy with or without irradiation in the treatment of breast cancer. N Engl J Med. 1995; 333(22):1456-61. DOI: 10.1056/NEJM199511303332203. View

12.

Prat F, Centarti M, Sibille A, Abou el Fadil F, Henry L, Chapelon J . Extracorporeal high-intensity focused ultrasound for VX2 liver tumors in the rabbit. Hepatology. 1995; 21(3):832-6. View

13.

Wang Z, Wu F, Wang Z, Zhang Z, Zou J, Liu C . Targeted damage effects of high intensity focused ultrasound (HIFU) on liver tissues of Guizhou Province miniswine. Ultrason Sonochem. 1997; 4(2):181-2. DOI: 10.1016/s1350-4177(97)00028-x. View

14.

Dowlatshahi K, Fan M, Gould V, Bloom K, Ali A . Stereotactically guided laser therapy of occult breast tumors: work-in-progress report. Arch Surg. 2000; 135(11):1345-52. DOI: 10.1001/archsurg.135.11.1345. View

15.

Vallancien G, Harouni M, Guillonneau B, Veillon B, BOUGARAN J . Ablation of superficial bladder tumors with focused extracorporeal pyrotherapy. Urology. 1996; 47(2):204-7. DOI: 10.1016/S0090-4295(99)80417-8. View

16.

Hynynen K, Pomeroy O, Smith D, Huber P, McDannold N, Kettenbach J . MR imaging-guided focused ultrasound surgery of fibroadenomas in the breast: a feasibility study. Radiology. 2001; 219(1):176-85. DOI: 10.1148/radiology.219.1.r01ap02176. View

17.

Staren E, Sabel M, Gianakakis L, Wiener G, Hart V, Gorski M . Cryosurgery of breast cancer. Arch Surg. 1997; 132(1):28-33; discussion 34. DOI: 10.1001/archsurg.1997.01430250030005. View

18.

Veronesi U, Luini A, Del Vecchio M, Greco M, Galimberti V, Merson M . Radiotherapy after breast-preserving surgery in women with localized cancer of the breast. N Engl J Med. 1993; 328(22):1587-91. DOI: 10.1056/NEJM199306033282202. View

19.

Wu F, Chen W, Bai J, Zou J, Wang Z, Zhu H . Pathological changes in human malignant carcinoma treated with high-intensity focused ultrasound. Ultrasound Med Biol. 2001; 27(8):1099-106. DOI: 10.1016/s0301-5629(01)00389-1. View

20.

McGahan J, Griffey S, Schneider P, Brock J, Jones C, Zhan S . Radio-frequency electrocautery ablation of mammary tissue in swine. Radiology. 2000; 217(2):471-6. DOI: 10.1148/radiology.217.2.r00nv37471. View