Ultrasound-guided Percutaneous Radiofrequency-assisted Breast Excision to Remove En-bloc Specimens: Five Years' Experience

Full Article

LMF Tee, CY Lui, KCH Lau, CY Fong, YCY Chan, M Ying, CM Chan

Hong Kong J Radiol 2014;17:98-108

DOI: 10.12809/hkjr1413208

Objectives: To describe our initial 5-year experience in using the radiofrequency-assisted excision technology in a regional hospital, with an emphasis on the efficacy, techniques, and safety of the procedure.

Methods: Clinical records and operative data of all patients who underwent ultrasound-guided radiofrequency-assisted excision of breast lesions between September 2008 and May 2013 in Kwong Wah Hospital, Hong Kong, were retrospectively reviewed.

Results: A total of 48 consecutive patients and 50 lesions with a mean diameter of 9.2 mm were included. Of the 50 lesions, 27 (54%) were graded Breast Imaging–Reporting and Data System (BI-RADS) 3, 21 (42%) BI-RADS 4, and 2 (4%) BI-RADS 5. The mean operating duration was 6.3 minutes. Final pathology showed 1 ductal carcinoma in-situ, 20 fibroadenomata, 11 fibrocystic changes, 9 papillomata, and 11 miscellaneous benign entities. Complete removal with histological clear margins was achieved in 82% of the lesions. No histological underestimation or recurrence was found on subsequent open surgery or follow-up. The procedure was well-tolerated, with a mean pain score of 1.35 out of 5. One patient (2%) experienced a complication of haematoma formation requiring surgical treatment.

Conclusion: Ultrasound-guided percutaneous radiofrequency-assisted breast excision is a robust diagnostic tool and therapeutic procedure that allows safe, quick, and efficacious en-bloc lesion removal with clear margins. This minimally invasive office procedure is a promising alternative to conventional open excision of benign breast lesions.








結果:連續48名患者(50例病變)被納入研究範圍,腫瘤的平均直徑為9.2 mm。50例中,屬於BI-RADS(乳房影像–報告與資料系統)三級的有27例(54%),BI-RADS四級的有21例(42%),BI-RADS五級的有2例(4%)。平均手術時間為6.3分鐘。最終的病理學結果發現有導管原位癌(1例)、乳腺纖維腺瘤(20例)、纖維囊性變(11例)、乳頭狀瘤(9例)和其他良性腫瘤(11例)。徹底切除且組織學上邊緣清晰的病變達82%。其後的外科開放手術或隨訪並無發現組織學的低估或復發。這種技術的病人耐受性良好,平均疼痛分數為1.35(最高分為5分)。一名患者(2%)併發血腫,需進行手術治療。