Thursday, January 21, 2010

Breast Focused Microwave Thermotherapy

I noticed this AP article, Microwave heat, chemotherapy combine to shrink breast cancer tumors, reduce mastectomies, in the health news earlier this week with this claim:

A University of Oklahoma researcher has found that microwave heat treatment combined with chemotherapy actually kills large breast cancer tumors and could reduce the need for mastectomies by nearly 90 percent.

I would love for this to turn out to be true, having begun medical school when Halsted mastectomies were still the standard of care. 

Preoperative focused microwave thermotherapy (FMT) is the focus of multi-institutional clinical studies from OU, the Massachusetts Institute of Technology, the Los Angeles Biomedical Research Institute, the Comprehensive Breast Center of Florida and St. Joseph's Hospital in California. 

Dr. William Dooley, director of surgical oncology at OU Cancer Institute, and colleagues   have published the results from early clinical trials online in the journal Annals of Surgical Oncology.

Cancer cells are sensitive to microwave-generated heat. FMT uses a minimally invasive approach to introduce energy into the tumor creating irreversible cell damage.

The current study looked at the effectiveness of preoperative FMT treatment used alone and in combination with preoperative anthracycline-based chemotherapy for breast tumors ranging in ultrasound-measured size from 0.8 to 7.8 cm.

In a randomized study for patients with early-stage invasive breast cancer, the researchers found of no patients receiving preoperative FMT (0/34) had positive tumor margins, whereas 9.8% of patients (4/41) who had breast conservative surgery (BCS) alone had positive margins.

In a randomized study for patients with large tumors, based on ultrasound measurements, the researchers found  the median tumor volume reduction was 88.4% (n = 14) for patients receiving FMT and neoadjuvant chemotherapy, compared with 58.8% (n = 10) reduction in the neoadjuvant chemotherapy-alone arm.

FMT can be safely administered in a preoperative setting.   Larger randomized studies are required to verify these conclusions.

 

 

REFERENCES

Focused Microwave Thermotherapy for Preoperative Treatment of Invasive Breast Cancer: A Review of Clinical Studies; Annals of Surgical Oncology, Online First - December , 2009; William C. Dooley MD, Hernan I. Vargas MD, Alan J. Fenn PhD, Mary Beth Tomaselli MD, Jay K. Harness MD

Randomized Study of Preoperative Focused Microwave Phased Array Thermotherapy for Early-Stage Invasive Breast Cancer; Cancer Therapy Vol 6, 395-408, 2008; William C. Dooley, Hernan I. Vargas, Alan J. Fenn, Mary Beth Tomaselli, Jay K. Harness

The Halsted Mastectomy: Present Illness and Past History; West J Med. 1981 June; 134(6): 549–555; Cordelia Shaw Bland (pdf file)

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