Microwave Ablation without Subsequent Lumpectomy versus Breast-Conserving Surgery for Early Breast Cancer: a Propensity Score Matching Study

Purpose: To compare the efficacy of ultrasound-guided percutaneous microwave ablation (MWA) without subsequent lumpectomy and breast-conserving surgery (BCS) in patients with early breast cancer (EBC).

Methods: This retrospective cohort study included 106 patients with EBC (T0/1/2 N0/1 M0) treated by BCS or MWA from October 2014 to December 2020 in a single institution. Propensity score matching (PSM) was performed at 1:1 to balance the baseline characteristics. The tumor progression, overall survival (OS), disease-specific survival (DSS), complications, and cosmetic results were compared.

Results: Before PSM, 21 patients underwent MWA and 85 patients underwent BCS were enrolled. After PSM, each group had 21 patients and the baseline characteristic were balanced. MWA needed shorter operative time (60min vs 101min, P0.99), and complications (0% vs 19%, P=0.58). All the patients in MWA group reported excellent cosmetic results but 29% of BCS patients expressed dissatisfaction for breast asymmetry (10%) and scar formation (29%)( P <0.001).

Conclusion: This preliminary study showed that in selected early breast cancer patients, microwave ablation without subsequent lumpectomy has comparable tumor control effect with breast-conserving surgery and better cosmetic results during an intermediate follow-up. Microwave ablation provides a safe and feasible choice for patients reluctant or intolerant to breastconserving surgery.

Author(s): Yu-qing Dai

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