Percutaneous Microwave Ablation versus Breast Conserving Surgery for 2-5cm Breast Cancer: A Two-Center, Retrospective Study

Research Square (Research Square)(2023)

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摘要
Abstract Objectives: To compare the prognosis, complication and cosmetic results of ultrasound-guided percutaneous microwave ablation (MWA) with those of breast-conserving surgery (BCS) for 2-5cm BC patients. Methods: This retrospective study was conducted in two academic centers, which enrolled 224 invasive BC patients treated with MWA (n=39) or BCS (n=185) from November 2015 to February 2022. Propensity score matching (PSM) was performed at 1:2 and the baseline characteristics were well balanced between MWA (n=32) and BCS (n=56) group thereafter. Prognosis was analyzed by the Kaplan-Meier curves. Association between treatment modality and disease-free survival (DFS) was assessed using seven different Cox proportional hazards models. Results: After PSM, during a median follow-up of 33 months (interquartile range: 21.25, 51.00 months), between MWA and BCS group, there was no statistic difference in 3-year DFS (95.03% vs 98.26%, P=0.171) and 3-year local tumor progression (LTP, 3.39% vs 1.20%, P =0.438). Statistically comparable DFS and LTP were also achieved for the 2-3 cm and 3-5 cm BC subgroups. Consistent results were validated by seven survival models in DFS (all, P>0.05). Compared to BCS, patients in MWA group reported better cosmetic results (P =0.004), spent shorter operative time (56.96 min vs 86.30 min, P=0.002), while with higher costs (24,063.85 RMB vs 15,399.32 RMB, P<0.001). Conclusion: With survival models validation, this pilot study suggests that MWA may be a potential alternative local therapy for selected 2-5cm BC patients, especially those not indicated for surgery. Complete ablation is the key to achieving no statistical difference between MWA and BCS.
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关键词
microwave,breast cancer,surgery,two-center
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