Palliative Radiofrequency Ablation of a Fungating, Symptomatic Breast Lesion
Eric vanSonnenberg1,
Sridhar Shankar2,3,
Leroy Parker4,
Lawrence Cheung2,
Paul R. Morrison2,
Stuart G. Silverman2 and
Dirk Igelhart5
1 Department of Radiology, Brigham and Women's Hospital, Boston, MA 02115.
2 Department of Radiology, Dana-Farber Cancer Institute, Brigham and Women's
Hospital, Harvard Medical School, Boston, MA.
3 University of Massachusetts Memorial Health Center, Worcester, MA 01655.
4 Department of Medical Oncology, Division of Breast Oncology, Dana-Farber
Cancer Insititute, Brigham and Women's Hospital, Harvard Medical School,
Boston, MA.
5 Department of Surgery, Dana-Farber Cancer Institute, Brigham and Women's
Hospital, Harvard Medical School, Boston, MA.
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Fig. 1A. —43-year-old woman with fungating breast lesion. Lesion is at
inframammary fold of reconstructed breast, the latter being cephalad to
lesion. Lesion is ulcerated and has areas of dried blood.
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Fig. 1B. —43-year-old woman with fungating breast lesion. CT-guided
radiofrequency ablation of fungating breast tumor with patient under general
anesthesia. Noncontrast supine CT scan shows radiofrequency needle probe
entering from patient's right in medial portion of tumor.
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Fig. 1C. —43-year-old woman with fungating breast lesion. Needle probe
is repositioned into lateral and outer portion of tumor for second
ablation.
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Fig. 1D. —43-year-old woman with fungating breast lesion. MRI pre- and
postradiofrequency ablation procedure, showing efficacy of ablation.
Preprocedure, T1-weighted spoiled gradient-echo MRI (D) (TR/TE, 7/2.2;
TI, 40; flip angle, 10°) after 20 mL of IV gadopentetate dimeglumine are
administered and using body coil. Lesion has enhanced notably with contrast
medium (arrows). After ablation, T1-weighted spoiled gradient-echo
MRI (E) (TR/TE, 7.7/2.028; TI, 40; flip angle, 10°) shows lack of
enhancement in lesion. Note deeper breath on MRI compared with CT, as the
patient was awake for MRI examination.
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Fig. 1E. —43-year-old woman with fungating breast lesion. MRI pre- and
postradiofrequency ablation procedure, showing efficacy of ablation.
Preprocedure, T1-weighted spoiled gradient-echo MRI (D) (TR/TE, 7/2.2;
TI, 40; flip angle, 10°) after 20 mL of IV gadopentetate dimeglumine are
administered and using body coil. Lesion has enhanced notably with contrast
medium (arrows). After ablation, T1-weighted spoiled gradient-echo
MRI (E) (TR/TE, 7.7/2.028; TI, 40; flip angle, 10°) shows lack of
enhancement in lesion. Note deeper breath on MRI compared with CT, as the
patient was awake for MRI examination.
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Fig. 1F. —43-year-old woman with fungating breast lesion. Two weeks
postradiofrequency ablation, lesion developed an eschar and was diminished in
size.
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Copyright © 2005 by the American Roentgen Ray Society.
