Vacuum-assisted Resection of Malignant Tumors with and without Subsequent Radiofrequency Ablation: Feasibility of Complete Tumor Treatment Tested in an Animal Model Thomas Boehm, MD, Ansgar Malich, MD, S. Nahum Goldberg, MD, Ju ¨ rgen R. Reichenbach, MD, Ingrid Hilger, MD, Marlies Fleck, MD, and Werner A. Kaiser, MD PURPOSE: To evaluate the feasibility of vacuum-assisted tumor excision with and without RF ablation for the minimally invasive treatment of small tumors. MATERIALS AND METHODS: Twenty VX2 tumors were implanted bilaterally into the spine muscle of 10 rabbits. Tumor excision was performed after tumor sizes reached 10 mm (12–27 d incubation) with use of a vacuum-assisted biopsy device. Three or four directed vacuum-assisted biopsies were performed in angle steps of 30°. In 10 tumors, ultrasound (US)-guided radiofrequency (RF) ablation (8 min, 60 W) was subsequently performed with use of a cooled-tip electrode system. Follow-up US was performed at 3– 4-day intervals for as long as 3 weeks after excision/RF ablation. Autopsy and histopathologic analysis were performed. RESULTS: The duration of vacuum excision ranged from 12 to 45 minutes (25 min  7). Histologically tumor-free margins in the outer round of the core biopsy specimens were found in only four of 20 cases (20%). Maximum lesion sizes during RF ablation ranged from 18 to 25 mm (20 mm  2.6). Histologic examination of the excision specimens documented tumor-free margins in only three tumors (30%) among the excision-only group and only one (10%) among the combined excision/ablation group. Local recurrences occurred in eight of 10 cases (80%) after vacuum excision alone, whereas recurrence after combined excision and RF ablation occurred only in two of 10 cases (20%; P < .05). CONCLUSIONS: Local tumor resection with use of vacuum-assisted biopsy is feasible and promising as a minimally invasive therapy for the treatment of small focal breast neoplasms. Combined excision and RF ablation techniques may reduce the rate of local recurrence considerably. Index terms: Animal model • Neoplasms, therapy • Radiofrequency (RF) ablation J Vasc Interv Radiol 2001; 12:1086 –1093 Abbreviations: MIBB = Minimally Invasive Breast Biopsy (device), RF = radiofrequency BREAST cancer is the most frequent cause of death in women in European countries such as Germany and its in- cidence is increasing progressively (1). In the United States, breast cancer is the most frequently diagnosed cancer in women, and it is the second most frequent cause of cancer death, ex- ceeded by only lung cancer (2). Ac- cording to data from the National Cancer Institute’s Surveillance, Epide- miology and End Results program (3), 32% of all incident cancers among women are breast cancers. The modern era of breast cancer sur- gery began with the introduction of radi- cal mastectomy by William Halsted in 1894 (4,5). However, the therapeutic strat- egy for the treatment of breast cancer has From the Department of Medical Radiology (T.B.), Institut für Diagnostische Radiologie, Universitätsspi- tal Zürich, Switzerland; Institute of Diagnostic and Interventional Radiology (A.M., J.R.R., I.H., M.F., W.A.K.), Friedrich-Schiller-Universität, Jena, Germa- ny; and Department of Radiology (S.N.G.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts. Received December 15, 2000; revision requested February 16, 2001; revision received April 30; accepted May 1. Address correspondence to T.B., Dpt. Medizinische Radiologie, Institut für Diag- nostische Radiologie, Universitätsspital Zürich, Rämistrae 100, CH-8091 Zürich, Switzerland; E-mail: thomas_boehm@gmx.net © SCVIR, 2001 1086