MR-guided Focused Ultrasound Surgery for Breast Cancer: Reliability and Effectiveness

Each year over one million women worldwide are diagnosed with breast cancer (BC), the second most common cancer in women. It is estimated there were 184,450 new BC cases and 40,930 deaths in 2008 in USA (1). The impact of BC is life-threat and cosmetic damage of the breast. Especially in consideration of early BC treatment, secure pursuit of breast conservation becomes the most significant issue for the patients. Standard treatment of BC consists of local and systemic controls. Surgery is the major method and radiation therapy, adjuvant in local control. Systemic control is mainly pharmaceutical therapy. During the past decades, local treatment of BC has improved dynamically from aggressive resection of the entire breast with pectoral muscles with the fatty tissues embedding axillary lymph nodes, towards less invasive procedures such as muscle conserving and breast conserving surgeries. Recent standard local treatment of early and localized BC is lumpectomy (excision of the tumor with adjacent tissues) with or without radiation therapy. Although conventional surgical lumpectomy is not a major procedure, it is still invasive and is cosmetically undesirable for most women. It would be advantageous to develop a non-invasive ablative method for treating patients with smaller tumors. There may be less morbidity and less cosmetic deformity if local control of breast cancer could be achieved without a surgical resection. In this lecture, a clinical study conducted to evaluate efficacy and safety of MRgFUS of BC in Japan is reported, and the current follow-up study and non-trial treatment are demonstrated.