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First published online October 26, 2006
British Journal of Radiology (2007) 80, 267-273
© 2007 British Institute of Radiology
doi: 10.1259/bjr/91383984
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Ultrasound-guided percutaneous radiofrequency ablation in elderly breast cancer patients: preliminary institutional experience

P-Y Marcy, MD 1 N Magné, MD, PhD 2 P Castadot, MD 2 C Bailet, MD 1 and M Namer, MD 3

1 Radiology Department, Centre Antoine Lacassagne, 06189 Nice, France, 2 Radiotherapy Department, Institut Jules Bordet, 1000 Bruxelles, Belgium, 3 Medical Oncology Department, Centre Antoine Lacassagne, 06189 Nice, France


Figure 1
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  		Figure 1. (a) Dynamic MRI sequences of the right breast after intravenous bolus injection of gadolinium. Serial T1 weighted gradient echo sequences before and 1 min, 2 min, 3 min and 6 min after gadolinium-DTPA intravenous bolus injection. Subtraction of pre-contrast from early post-contrast images shows a single 16 mm early contrast nodular enhancement before RFA. Its location is distant to the overlying skin, to the nipple area and to the pectoralis muscle. (b) MRI (sequence T1) at 1 month. Note the 50 mmx35 mm well-defined hypointense area delineated by a tiny contrast enhancement at the periphery, which is supposed to correspond to reactive granulation tissue around the avascular treated area.

 

Figure 2
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  		Figure 2. Lateral mammograms before and 6 months after RFA. The typically malignant 22 mm opacity in the upper right breast is distant to the skin and the nipple before treatment; fat necrosis is shown after RFA.

 

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  		Figure 3. (a) Local recurrence. Appearance of a tiny opacity within the margin of the fat necrosis on mammogram. (b) Corresponding ultrasound image showing a solid mural nodule at the border of the oil cyst. Cytological aspiration was positive for invasive carcinoma. Note the vicinity of the tumour to the skin.

 

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  		Figure 4. Dynamic MRI of the treatment area at 3 months and 6 months, before and 1 min, 2 min, 3 min, 4 min and 6 min after intravenous gadolinium. Note the three distinct areas of the breast: the nipple area enhances early; the 50 mmx70 mm central fat necrosis does not enhance at all; the peripheral area (area 2) abnormally. 3 months later, an air–fluid level developed within the fat necrosis, the hypervascular margin was proved to be the granuloma located at the periphery of the pyogenic abscess.

 




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