[NONSURGICAL ABLATION THERAPY FOR SMALL BREAST CARCINOMAS].

Nihon Geka Gakkai zasshi Pub Date : 2016-11-01
Takayuki Kinoshita
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Abstract

Breast-conserving therapy was introduced in Japan in the 1980s as a local treatment for early-stage disease used under cautiously developed criteria. Its indications have gradually been expanded by, for example, the addition of concomitant preoperative chemotherapy. More than half of breast cancer patients currently benefit from this treatment. Recently, nonsurgical ablative therapies have been tested as a definitive conservative treatment. Clinical studies on high-intensity focused ultrasound (HIFU) and cryoablation began in 2004 and 2006, respectively. Phase I and phase II multicenter clinical trials of radiofrequency ablation (RFA) as a treatment for early-stage breast cancer were started in 2006 under the Evaluation System of Investigational Medical Care. A prospective phase III trial was started in 2013 under the Advanced Medical Service System. Data on nonsurgical ablative therapies including RFA, cryoablation, and HIFU are steadily accumulating. We believe that these therapies can replace lumpectomy, the current standard treatment for early breast cancer, in the near future.

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[小乳腺癌的非手术消融治疗]。
20世纪80年代,日本引入了保乳疗法,作为一种根据谨慎制定的标准对早期疾病进行的局部治疗。它的适应症已逐渐扩大,例如,增加了术前化疗。目前,超过一半的乳腺癌患者受益于这种治疗。最近,非手术消融治疗已被测试作为一个明确的保守治疗。高强度聚焦超声(HIFU)和冷冻消融的临床研究分别开始于2004年和2006年。射频消融(RFA)作为早期乳腺癌治疗的I期和II期多中心临床试验于2006年在研究性医疗保健评估系统下启动。2013年,在先进医疗服务系统下开始了一项前瞻性III期试验。包括RFA、冷冻消融和HIFU在内的非手术消融治疗的数据正在稳步积累。我们相信,在不久的将来,这些疗法可以取代目前早期乳腺癌的标准治疗——乳房肿瘤切除术。
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