الفهرس 
Anatomy of the Female BreastOnly 14 pages are availabe for public view
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Abstract
The goal of breast conservation treatment is complete removal of the malignant breast tumor and a surrounding rim of normal breast tissue. The oncologic principle of complete tumor resection including a surrounding rim of non malignant tissue to reduce local recurrence rate is followed with a secondary goal being the maintenance of an adequate amount of non-malignant breast tissue to produce a normal breast contour thus the term breast conservation [112].
Technology advances over the last decade have fueled interest in even less invasive local treatments for patients with breast carcinoma. Minimally invasive thermal destruction rather than surgical excision of early stage primary breast tumors may be appropriate in carefully selected patients. One treatment technique that allows in-situ percutaneous destruction of a breast tumor is radio- frequency ablation. The objective of RFA is clearance of the local disease with a margin of clear tissue [80].
Several devices are currently available for RF thermal ablation. The fundamental components common to all systems include a RF generator, an active electrode and a reference electrode [57].
For successful RFA treatment, the breast carcinoma needs to be a centrally located mass, less than 30 mm in diameter and distant to the skin and the pectoralis muscle by at least 1cm [73].
Radiofrequency ablation uses thermal energy to destroy tumor cells. Planning is performed to locate the tumor and a special needle is introduced into the tumor using direct image guidance, the needle is attached to a radiofrequency generator which sends radiofrequency through the needle, which generates heat from frictional movement of ions. The heat destroys the tumor cells. After being destroyed, the dead tissue is absorbed by the body, leaving a normal appearing breast without a scar [113].
Follow up by clinical examination and breast imaging (U/S, Contrast-enhanced CT and MRI when possible), should be done immediately after the procedure (within 24 hours), 1 month, 3 months and every 3months during the first year, and every 6 months during the second year. The goal of long-term follow-up is to detect untreated residual and recurrent tumor [88].
RFA is safe, feasible and a promising minimally invasive treatment for small breast carcinomas, recurrent tumors and patients who would not be considered candidates for surgery due to age, co-morbidity, or extent of disease [101].
RFA can be performed without affecting the patient’s overall health provides good local control, excellent cosmetic, effective cell killing with a low complication rate and most people can resume their usual activities in a few days [99].
Although RFA is relatively safe and minimally invasive, the benefits do not come without slight risks. The complication may include bleeding, minor burn, infection, fever and post ablation syndrome. The risks are kept to a minimum by attention to detail as well as continuous monitoring of vital signs. Complications are usually managed nonoperatively [114].
A major limitation of RF ablation and other percutaneous ablation techniques is the inability to assess the margins of the ablated lesion. Currently, only surgical resection of malignant tumors enables one to evaluate the margins of the specimens to ensure removal of the entire tumor and a safe amount of tissue around it and thus minimize the risk of local tumor recurrence [111].
Additional research, further large comparative studies and the long term effects of RFA on the breast tissues will be needed to determine if local ablative therapies like RFA will really be the next step forward in the management of breast cancer [84].