Microwave ablation without subsequent lumpectomy versus breast-conserving surgery for early breast cancer: a propensity score matching study

Abstract

Purpose

To compare the efficacy of ultrasound-guided percutaneous microwave ablation (MWA) without subsequent lumpectomy and breast-conserving surgery (BCS) in patients with early breast cancer (BC).

Materials and methods

This retrospective cohort study enrolled 106 patients with early BC (T_0/1/2 N_0/1 M₀) treated by MWA (n = 21) or BCS (n = 85) from October 2014 to December 2020. Propensity score matching (PSM) was performed to balance the baseline characteristics between MWA and BCS groups. The tumor progression, overall survival (OS), disease-specific survival (DSS), complications, and cosmetic results were compared.

Results

After PSM, there were 21 patients with balanced baseline characteristics in each group. After a median follow-up of 43 months (range, 15–89 months), there was no significant difference in tumor progression (10% vs 2%, p = 0.18), OS (96% vs 99%, p = 0.36), DSS (100% vs 99%, p > 0.99), and complications (0% vs 19%, p = 0.58). The operation time of MWA was shorter (60 min vs 101 min, p < 0.001) than that of BCS. For the management of metastatic lymph nodes, five (5/21, 24%) patients with six metastatic nodes underwent ablation in the MWA group and three patients (3/21, 14%) with six metastatic nodes underwent axillary lymph node dissection in the BCS group. All the patients in the MWA group reported excellent cosmetic results, but 29% of BCS patients expressed dissatisfaction with breast asymmetry (10%) and scar formation (19%) (p < 0.001).

Conclusion

This pilot study indicated that in selected early BC patients, microwave ablation without subsequent lumpectomy had comparable tumor control effect with breast-conserving surgery and better cosmetic results at an intermediate follow-up.

Highlights

• MWA without subsequent lumpectomy has a comparable interim survival effect and better cosmetic results as BCS in the treatment of selected early breast cancer.

• MWA has the potential to be a viable and promising therapeutic option for breast cancer patients reluctant or intolerant to surgery with the advantage of minimal invasion.

Keywords:

• Microwaves
• retrospective studies
• propensity score
• breast neoplasms
• ultrasonography
• interventional

Author contributions

Dr Yu had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: Yu-qing Dai, Ping Liang, Jie Yu; Acquisition of data: Yu-qing Dai, Ping Liang, Xiao-Ling Yu, Zhi-Yu Han, Fang-yi Liu, Xin Li, Shui-lian Tan, Zhen Wang, Chong Wu, Jian-ming Li, Jie Yu; Analysis and interpretation of data: Yu-qing Dai, Yan-chun Luo, Jie Yu; Drafting of the manuscript: Yu-qing Dai, Jie Yu; Critical revision of the manuscript for important intellectual content: Yu-qing Dai, Jie Yu.

Disclosure statement

We declare that the submitted manuscript does not contain previously published material, and are not under consideration for publication elsewhere. Each author has made an important scientific contribution to the study and is thoroughly familiar with the primary data. All authors listed have read the complete manuscript and have approved the submission of the paper. The manuscript is truthful original work without fabrication, fraud or plagiarism. All authors declare that there is no conflict of interest.

Data availability statement

We understand the terms of the share upon reasonable request data policy and our data generated or analyzed during the study are available from the corresponding author by request.

Additional information

Funding

This work was not funded.