[MOL] LASER ABLATION THERAPY AIMED AT SMALL BREAST TUMORS [01163] Medicine On Line


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[MOL] LASER ABLATION THERAPY AIMED AT SMALL BREAST TUMORS



Good Day My Friends,

Hope the folling information may be of some value.

LASER ABLATION THERAPY AIMED AT SMALL BREAST TUMORS
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CHICAGO--For small breast tumors, interstitial laser therapy may 
become a woman’s primary therapy.

So suggests a Rush-Presbyterian-St.Luke’s oncology team here that 
has used minimally invasive, stereotactically guided laser ablation 
to treat 36 women with invasive or in situ ductal carcinoma. The 
researchers describe their investigation as a "work in progress." 
Their goal is a less painful and aesthetically more pleasing therapy.


The women had nonpalpable tumors detected by mammography that were up 
to 2 cm in diameter, and the nearest border was 1 cm away from the 
skin or the chest wall. Two women had been diagnosed with ductal 
carcinoma in situ and 34 with suspicious masses. Needle-core biopsy 
showed invasive ductal carcinoma in 29 patients, invasive lobular 
carcinoma in five, and DCIS in two.

They were invited to undergo initial laser treatment before 
undergoing lumpectomy and axillary-node dissection or, more recently, 
sentinel-node biopsy, plus standard adjuvant therapy and 
hormonal therapy. One patient had a mastectomy.

The investigators say they found that tumors smaller than 1.5 cm may 

be completely destroyed within the breast by percutaneously 
transmitted laser energy via an optic fiber placed inside a needle 
and stereotactically guided to the center of the tumor. The
outpatient therapy was performed under local anesthesia.

Total tumor ablation with negative margins was observed whenever 
2,500 J/ml of tumor was given or thermal sensors recorded 60 degrees C, 
Dr. Kambiz Dowlatshahi and colleagues reported in the November 
Archives of Surgery. The actual amount of laser energy given to cause 
ablation of the tumor ranged from 2,500 to 10,000 J (mean, 5,650).

A week after laser therapy, microscopic examination showed 
disintegration of malignant cells, with peripheral acute inflammatory 
response. After four to eight weeks, there was extensive fibrosis.
Contrast-enhanced color Doppler revealed loss of tumor circulation 
after therapy, and PET scans correlated with histologic findings.

There were no systemic adverse effects. Two patients had 3-by 4-mm 
skin burns around the laser needle. The authors said tumors with 
undefined borders, invasive lobular carcinoma, and those with 
scattered microcalcifications are unsuitable for the laser therapy, 
as are tumors less than 1 cm from the surface or the chest wall.


God Bless YOu all,
marty auslander
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