The tip of the spear.

Who sees breast cancer before any of us? That’s right, radiology. In this Spanish randomized phase 2 trial, women with early stage breast cancer ≤ 2 cm in size were randomized to receive neoadjuvant radiofrequency ablation (RFA) + lumpectomy or lumpectomy alone. Among the 40 patients enrolled, those who had RFA had a much lower rate of positive surgical margins (55 → 20%) and a large proportion of non-viable tumor cells. However, RFA also resulted in higher rates of infection and post-op breast inflammation. The big kicker here is that there was no standard of care adjuvant radiation. While this could be a good alternative treatment option for the few women with contraindications to radiation, we’re gonna need much bigger trials including standard adjuvant radiation to fully understand any actual benefits here. TBL: Pre-lumpectomy RFA may reduce positive margin rates and tumor cell viability. | Garcia-Tejedor, Radiology 2018