A new procedure being tested at Rush-Presbyterian-St. Luke's Medical Center in Chicago holds much promise for eliminating the need for surgery in women with small breast cancers. This procedure uses a laser delivered through a needle to destroy tumors detected by mammography.
Improvements in breast imaging have made it possible for doctors to find and diagnose breast cancer at a very early stage. "As more women take annual mammograms, we are able to detect these tumors when they are very small," said Dr. Kambiz Dowlat, a surgeon at Rush. "We should therefore offer a treatment which is aesthetically more pleasing and yet equally effective as lumpectomy."
During this new procedure the patient lies face down on a special (stereotactic) x-ray table enabling the doctor to have precise visualization of the tumor. Under local anesthesia the laser needle is inserted into the tumor and the second needle (thermometer) is placed next to it. Laser energy is then delivered through a thin fiber inside the laser needle until the temperature around the tumor reaches 140°F, at which point all cancer cells are destroyed. The entire procedure takes approximately one hour and the patient is kept under observation for another hour before leaving the hospital. "To satisfy the rigorous requirements of this clinical trial, these women must also have lumpectomy afterwards to prove that the laser beam has killed all the cancer cells," Dowlat said. "Once the therapy is approved, patients will not have to undergo the additional lumpectomy," he stressed.
In preliminary trials using laser therapy, 40 patients with breast cancer have been treated with no complications other than minimal pain requiring Tylenol tablets. Dowlat emphasized that laser therapy is not appropriate for women with large breast cancers or those which cannot be clearly seen on mammogram.
Breast cancer affects one in eight women in the United States and is the most commonly diagnosed form of cancer among women. Funding for this clinical trial comes from the Mark Kay Ask Charitable Foundation and the Bears Care Foundation.