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Pilot Study of Radiofrequency Ablation of Breast Cancer Lumpectomy Sites to Decrease Re-operation

Phase 1
Completed
Conditions
Cancer of the Breast
Interventions
Device: AngioDynamics (previously RITA Med,Inc) radiofrequency delivery system (consisting of a generator and Starburst XL probe)
Registration Number
NCT00571987
Lead Sponsor
University of Arkansas
Brief Summary

In this protocol we combine two available and reliable treatments - lumpectomy and RFA. This combination method will provide for excision of the cancer as routinely accomplished and ablation of the cancer bed (lumpectomy site) to ensure negative margins without removing large volumes of tissue. This combined open technique will allow for full histologic analysis of the primary tumor and margin. Because no extra tissue is removed from the breast to generate negative margins it will result in better cosmesis than re-excision to obtain negative margins.

Detailed Description

While RFA alone is not approved for tumor destruction in breast it is FDA-approved for ablation of soft tissue after the breast cancer is removed. This study seeks to remove the tumor and then ablate a tumor-free zone (margin) of tissue around the lumpectomy site instead of removing more tissue. The primary short-term goal is to obviate the need for re-excision in the event of close or positive margins (\< 3 mm) which occurs on average in \~40 percent of the cases. Permanent pathology is only an estimation of margin status since 90% of recurrences occur at the site of the original lumpectomy. RFA ensures a sterilized margin regardless of the accuracy of the permanent pathology.

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
107
Inclusion Criteria
  • Female, 18-100 years old
  • Not pregnant or breastfeeding
  • Pre-study radiologic documentation of:
  • size ≤ 5 cm
  • unicentric, unilateral
  • suspicious mass or calcification
  • BIRADS classification ≥ IV
  • location of abnormality > 1 cm from skin
  • Ductal or Infiltrating Ductal Carcinoma
  • Grade I-III on final pathology
  • Good general health
  • Zubrod Performance Status of 0,1, or 2
  • No previous chemotherapy
  • No palpable axillary or supraclavicular lymph nodes
  • If prior non-breast malignancy, must have > 5 year disease-free survival
Exclusion Criteria
  • Patient < 18 y/o or > 100 y/o
  • Pregnant or breastfeeding
  • Male
  • Breast implants
  • Multicentric disease or bilateral disease
  • Lesions > 5 cm in diameter
  • Lesions < 1.0 cm from the skin
  • Previous prior radiation to the breast
  • Need for mastectomy
  • Diffuse microcalcifications (as determined by the Investigator)

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
1AngioDynamics (previously RITA Med,Inc) radiofrequency delivery system (consisting of a generator and Starburst XL probe)This is a non-randomized one arm study, all subjects receive treatment (radiofrequency ablation).
Primary Outcome Measures
NameTimeMethod
Number of Patients Requiring 2nd Surgery for Close or Positive MarginsMargins assessed at Final Pathology, approximately 1 week post-RF surgery

A "close" surgical margin implies that cancer cells are found on pathology to be very close to the surgical margin, and a "wide" surgical margin implies the tumor exists far from the cut edge or the surgical margin. For this study, we defined "close" as less than 3 mm.

Secondary Outcome Measures
NameTimeMethod
Recurrence of Breast Cancer at Prior Site of DiseaseUntil study end (2 years)

Trial Locations

Locations (1)

University of Arkansas For Medical Sciences

🇺🇸

Little Rock, Arkansas, United States

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