Breast Cancer

Background

Outside Approval SquareBreast cancer is the most common cancer in women. There are an estimated 232,000 new cases in women and more than 2,000 new cases in men annually, and more than 40,000 deaths occur each year.

Current Treatment

Common treatment options for breast cancer include surgery, radiation, chemotherapy, hormone therapy, and biologically targeted pharmacologic therapies. Typical treatment regimens can involve combinations of several options. However, the precise treatment regimen depends on the location, type, hormonal status and stage of the cancer, as well as decisions by the patient and care team.  

Clinical Trials Square

Focused Ultrasound Therapy

Focused ultrasound offers a potentially non-invasive alternative to surgical lumpectomy. Rather than creating an incision to remove the tumor, the physician uses magnetic resonance imaging (MRI) or ultrasound guidance to identify the tumor and to direct a focused beam of acoustic energy through the skin into the tumor. This beam heats and destroys the tumor without damaging nearby structures or tissues. A follow-up MRI can determine whether the entire tumor has been destroyed, and if necessary, focused ultrasound can be repeated. 

As a non-invasive method of lumpectomy, focused ultrasound may offer fewer complications and shorter recovery time than conventional surgery, no scars and reduced risk for breast deformation, and more precise treatment due to real-time guidance during the procedure. 

Because there is no surgical removal of tissue, there are some drawbacks to focused ultrasound treatment. Typically, the removed tissue is used to verify complete tumor removal and analysis and planning for adjuvant therapy. 

There is also the potential to use focused ultrasound in premenopausal patients to provide ovarian castration if the patient’s cancer is positive to estrogen and progesterone after a mastectomy. The conventional approach to this care is radiation therapy. A study compared the two, and found that focused ultrasound was superior to radiation therapy in terms its minimal invasiveness and faster efficacy. 

Regulatory Approval and Reimbursement

The Model JC Focused Tumor Treatment System, which is manufactured by Chongqing Haifu Technology, has been approved in Europe for the treatment of breast cancer.

The use of focused ultrasound to treat breast cancer is not yet a procedure universally reimbursed by medical insurance providers in the US.

Treatment Sites

While treatment is not approved in the United States, there are sites overseas that offer this treatment.

Please see here for a list

Clinical Trials

See here for a list of clinical trials for breast cancer using focused ultrasound

Notable Papers

Kamali Tafreshi A, Top C, Gencer N. 2-D multi-frequency imaging of a tumor inclusion in homogeneousbreast phantom using harmonic motion doppler imaging method. Phys Med Biol. 2017 Feb 2. doi: 10.1088/1361-6560/aa5de1. 

Mauri G, Sconfienza LM, Pescatori LC, Fedeli MP, Alì M, Di Leo G, Sardanelli F. Technical success, technique efficacy and complications of minimally-invasive imaging-guided percutaneous ablation procedures of breast cancer: A systematic review and meta-analysis. Eur Radiol. 2017 Jan 3. doi: 10.1007/s00330-016-4668-9. 

Fleming MM, Holbrook AI, Newell MS. Update on Image-Guided Percutaneous Ablation of Breast Cancer. AJR Am J Roentgenol. 2017 Feb;208(2):267-274. doi: 10.2214/AJR.16.17129. Epub 2016 Oct 20. 

Peek MC, Ahmed M, Napoli A, Usiskin S, Baker R, Douek M. Minimally invasive ablative techniques in the treatment of breast cancer: a systematic review and meta-analysis. Int J Hyperthermia. 2016 Oct 2:1-12.

Merckel LG, Knuttel FM, Deckers R, van Dalen T, Schubert G, Peters NH, Weits T, van Diest PJ, Mali WP, Vaessen PH, van Gorp JM, Moonen CT, Bartels LW, van den Bosch MA. First clinical experience with a dedicated MRI-guided high-intensity focused ultrasound system for breast cancer ablation. Eur Radiol. 2016 Feb 6.

Alkins R, Burgess A, Kerbel R, Wels WS, Hynynen K. Early treatment of HER2-amplified brain tumors with targeted NK-92 cells and focused ultrasound improves survival. Neuro Oncol. 2016 Jan 26. pii: nov318.

Peek MC, Ahmed M, Pinder SE, Douek M. A review of ablative techniques in the treatment of breast fibroadenomata. J Ther Ultrasound. 2016 Jan 19;4:1. doi: 10.1186/s40349-016-0045-z. eCollection 2016.

Knuttel FM, Waaijer L, Merckel LG, van den Bosch MA, Witkamp AJ, Deckers R, van Diest PJ. Histopathology of breast cancer after magnetic resonance-guided high intensity focused ultrasound and radiofrequency ablation. Histopathology. 2016 Jan 5. doi: 10.1111/his.12926.

Hsiao YH, Kuo SJ, Tsai HD, Chou MC, Yeh GP. Clinical Application of High-intensity Focused Ultrasound in Cancer Therapy. J Cancer. 2016 Jan 3;7(3):225-31. doi: 10.7150/jca.13906. eCollection 2016.

Li S, Wu PH. Comparison of magnetic resonance- and ultrasound-guided high-intensity focused ultrasound in the treatment of breast cancer. Chin J Cancer. 2013 Aug;32(8):441-52. Epub2012 Dec 14.

Merckel LG, Bartels LW, Köhler MO, van den Bongard HJ, Deckers R, Mali WP, Binkert CA, Moonen CT, Gilhuijs KG, van den Bosch MA. MR-guided high-intensity focused ultrasound ablation of breast cancer with a dedicated breast platform. Cardiovasc Intervent Radiol.2013 Apr;36(2):292-301. Epub2012 Dec 12.

Wang SW, He XY, Li MZ. High-intensity focused ultrasound compared with irradiation for ovarian castration in premenopausal females with hormone receptor-positive breast cancer after radical mastectomy. Oncol Lett. 2012 Nov;4(5):1087-1091. Epub 2012 Aug 13.

Furusawa H, Namba K, Nakahara H, Tanaka C, Yasuda Y, Hirabara E, Imahariyama M, Komaki K. The evolving non-surgical ablation of breast cancer: MR guided focused ultrasound (MRgFUS). Breast Cancer 2007;14(1):55-8.

Wu F, Wang ZB, Cao YD, Zhu XQ, Zhu H, Chen WZ, Zou JZ. “Wide local ablation” of localized breast cancer using high intensity focused ultrasound. J Surg Oncol 2007 Aug 1;96(2):130-6.

Click here for additional references from PubMed.

Video courtesy of InSightec

     

Share this page