Lumpectomy is the surgery commonly used for the removal of breast tumours. It is a conservative surgery in which, in addition to the tumour, a small portion of the surrounding healthy tissue is removed. A multidisciplinary team from the Bellvitge University Hospital (HUB) and the Catalan Institute of Oncology (ICO) has launched a clinical trial within the Functional Breast Unit to evaluate the results of removing breast cancer tumour cells at an early stage using radiofrequency ablation.
Professionals from the HUB's Functional Breast Unit (Radiodiagnosis, Pathology, Gynaecology) and the ICO (Medical Oncology) began working on the definition of this procedure between 2013 and 2017. In 2018, data from the phase II clinical trial were published in a high-impact journal (García-Tejedor A, Guma A, Soler T, Valdivieso A, Petit A, Contreras N, Chappuis CG, Falo C, Pernas S, Amselem A, Plà MJ, Fernández-Montolí E, Burdío F, Ponce J. Radiofrequency Ablation Followed by Surgical Excision versus Lumpectomy for Early Stage Breast Cancer: A Randomized Phase II Clinical Trial. Radiology. 2018 Nov;289(2):317-324).
The trial compared the results of radiofrequency ablation of breast cancer with standard lumpectomy treatment in 40 patients with an invasive breast carcinoma of 2 cm or less and a mean age of 64 years.
The results of the trial served to validate the radiofrequency technique and to demonstrate pathologically the absence of tumour viability, without affecting the rate of affected margins or surgical reinterventions.
According to Dr Amparo Garcia Tejedor from the Gynecology Service and Dr. Anna Gumà, Head of the Breast Section in the Diagnostic Imaging Service at HUB, radiofrequency is a less invasive procedure than surgery. It is performed with radiological control and can be done under local anaesthesia, providing precise results in tumour and margin destruction while potentially avoiding surgery's adverse effects. Despite positive results from the first trial, lumpectomy remains the standard clinical approach for tumours. The success of the initial trial led to a new phase in 2020, exclusively treating 14 women's breast cancer with radiofrequency. The trial aims to include a minimum of 30 cases, which the researchers consider a critical mass to evaluate results and compare survival and recurrence rates with surgery.
The number of patients eligible for radiofrequency ablation treatment with guarantees is limited. For this reason, Drs García and Gumà consider it essential that other centres join the trial. In this regard, it is worth mentioning that the Hospital del Mar performed one of the first radiofrequency ablations in breast cancer at the centre last June, adding it to the group of cases carried out so far.
In the opinion of Dr. Sonia Pernas, head of the Breast Cancer Unit of the ICO Medical Oncology Service, "this study is the result of the tenacity and determination of some researchers. This is worth being highlighted, since it is not always easy to carry out projects like this one. On the other hand, it also demonstrates the importance of multidisciplinary collaboration between different services and centres for the benefit of cancer patients"