Minimally invasive treatment of breast cancer: In recent years, various minimally invasive treatment as well as a local non-invasive treatment for those patients with early breast cancer similar efficacy compared to conventional surgery, and more acceptable to patients, in addition to the comprehensive treatment makes no reasonable few patients benefit.
radiofrequency ablation (RFA): Many studies suggest thatRFAmay be an early breast cancer , the treatment of small breast cancer may choose one of the means.
Indications:
aBsuper,MRIto determine tumor extent, tumor size should be shipped20mm;
b.away from the skin or chest wall tumors should note that 10mm, and not involving the epidermis;
c.avoid the menstrual period;
d.blood should be done before surgery, three coagulation, liver and kidney function tests.
Treatment is simple, the patient supine, under the guidance of the B-confirmed tumor size, scope, setting the treatment target, to include the surrounding normal tissue 0.5cm, treatment time is generally set at10 to 15minutes.After a few days tooneweek, review B-, or CT,MRIunderstand the treatment effect, if residual, repeat the treatment to be cut once or diverted to do surgery.
HIFU: HIFU applied to breast cancer treatment and success.The technology as a local treatment, often after neoadjuvant chemotherapy in the primary tumor or reduce the time application of HIFU of breast-conserving treatment of regional lymph node dissection do not only cure the cancer but also breast-conserving, and other breast cancer treatment has a good complementary.
Used in the treatment of B-implementation process monitoring, to prevent the departure from the organization caused by accidental injury, immediately determine the therapeutic effect, according to immediate changes in radiological dose adjustments, in the shortest possible time was the most satisfactory treatment.Because of the high intensity focused ultrasound treatment of the energy distribution of complete, uniform, in the treatment of the dose at any point are equal, will not cause mass residues.
Minimally invasive treatment of breast cancer indications and precautions:
a. I "IIbreast cancer; recurrence after surgical resection;
b.a single primary tumor and the volume<5cm;
c.cover the full range of lesions including foci around1. 5-2cmof breast tissue;
d.foci away from the surface of breast cancer should be based on the location, breast size to determine the treatment of high-frequency or low frequency probe, in general, superficial foci can choose the length of the sound wave, good resolution, high penetrating power of a relatively weak frequency therapy probe;
e.the formation of lumps after treatment, to be slowly absorbed, should review and identify residual tumor;
f.General first intervention, comprehensive treatment of chemotherapy before making HIFU treatment, the overlay treatment effect, side effects.
Contraindications:
Multi-center 'of breast cancer;ill "Nof the breast, subareolar breast cancer.
minimally invasive breast biopsy system (mammotome): minimally invasive breast biopsy system, mainly by peeling knife and the two devices constitute a vacuum suction pump.Into the tumor tissue does not quit after the case jackets repeated needle rotary cutting, edge cutting edge of negative pressure suction from the vacuum suction pump cut materials sent through the delivery device in vitro, making histological pathology.
Minimally invasive treatment of breast cancer indications and contraindications:
a.single or multiple masses of young women, especially for the mass position and depth, range is greater, but the mass transport maximum diameter of35mm;
b.difficult to locate the occult mass or calcification is difficult to characterize;
c.In case of multiple tumors, there is a suspected malignancy, biopsy should be addressed when the pathology, diagnosis of malignant lesions clear, the breast cancer treatment should be, otherwise you can continue peeling the other mass;
d.a bleeding tendency, coagulation system disorders, menstrual period, pregnancy, lactation, diabetes or suspected breast hemangioma should be considered as taboo.
Minimally invasive breast biopsy system, initially suspicious breast lesions as a special diagnostic equipment, has more applications were minimally invasive treatment of breast tumors.South KoreaMizmediHospital, 282 patients with breast centers use the system as a positive diagnosis of breast mass detection rate was 100%, which found that59were malignant and11cases of early carcinoma in situ, so that patients receive timely treatment.The precise navigation and positioning system, simple and flexible, complete excision of, minimally invasive scar deformation after the appearance of the breast, diagnosis and treatment of its unique development with the current trend of minimally invasive surgery, was welcomed by the majority of patients .Currently in Beijing, Shanghai, Guangzhou, Hunan, and many hospitals have conducted thousands of surgeries, the effect is good, the longest follow-up time has been more than three years, showed no local recurrence.
oxygen and nitrogen targeted therapy indications and precautions:
a.patients with a strong appearance requirements or do not want radical breast surgery;
b.for<5cmin diameter, and from the surface>lcmbreast good and evil 'of mass;
c.frail, poor general condition, with severe heart, lung, liver, kidney diseases and blood coagulation abnormalities should be regarded as a taboo;
d.If the preoperative signs of axillary lymph node, you need to do another incision in the axillary area to be cleaned.
Operation:
Were treated with local anesthesia, B-orientation, based on tumor size, choose the appropriate diameter superconducting knife, piercing the tumor under the guidance of B-body, open surgery system superconducting oxygen and nitrogen, frozenfor 15minutes, heatingfor 5minutes, two cycles treatment is completed.Patients with B-monitored continuously to confirm complete coverage of ice hockey has been around the0.5-lcmbeyond the tumor was destroyed.At the same time, intraoperative radiation therapy can also be implanted in the tumor particles or chemotherapy around the particles, in order to reduce the probability of tumor recurrence.
laser treatment technology:
Indications and precautions:
a.do not want to undergo surgery of benign and malignant breast superficial;
b.for<lcm Qiejutibiao> lcmbreast cancer,>lcmof the tumor should be used with caution;
c.breast cancer after radical surgery for the treatment of chest wall tumor recurrence;
d.breast thin;
e.laser treatment to protect the surrounding skin area;
f.appropriate application of analgesics.
How-to: patient supine, local anesthesia, the first needle into the tumor tissue with casing depths, and then the channel into and out of fiber-optic probe to the top few millimeters, while exposure to gradually retreat into the tumor edge to the most superficial probe Ministry of multi-point operation is completed, the surgical dressing, the end of surgery.After two weeks of liquefaction necrosis of tumor cells in order to facilitate the smooth fluid loss leads to necrosis, may make a small incision in the surgical field as a drainage channel in order to facilitate wound healing.
electrochemical treatment:
Indications:
a.unwilling to accept the breast surgery, cancer;
b.after surgery or radiotherapy, residual tumor, local recurrence or metastasis can not surgery or radiotherapy.
Contraindications: Systemic metastasis in patients with advanced widespread.
How:Bsuper-positioning, local anesthesia, according to localization, insertion of multiple uranium lily (diameter 0.7mm, length150mm)through the tumor diameter, applied by a computer-controlled electrochemical treatment for the start of treatment, time15 to 20minutes.If treatments can be divided into a larger tumor volume.
percutaneous implantation of sustained-release chemotherapy drugs
:5-FUapplication of sustained release granules implanted in target tumor tissue, by way of drug delivery for therapeutic purposes.Drug clinically proven to plant7 to 10days after the breast tumor tissue is still very high concentrations of 5-FU, patients with breast cancer can spread to the axillary lymph nodes.Resected tumor specimens histologically evident necrosis seen in cancer cells, shrink tumors after treatment for three months more than half of current clinical application of more than a thousand patients without systemic and local adverse reactions.
Indications:
a.advanced breast cancer patients;
h.serious organ disease can not afford surgery;
c.I do not want surgery patients.
Operation:
B-confirmed breast cancer site, the base and the distance from the surface, size, shape, peripheral invasion range.The number of initial decision point and the implantation of implantable drug total dose.Should avoid blood vessels and nerves,lcmaway from the tumor margin at the selected point of planting drugs, adjacent to the3cmdistance between two points or so.After local anesthesia, with special trocar into the tumor and surrounding percutaneous organization, the implantation of drug, particle radiation therapy can also be implanted at the same time.Medication once a month according to the disease, but also with systemic chemotherapy, but the drug should pay attention to the total.
Law can be the site of the tumor may spread to do preventive medicine, but also with cryosurgical applications, the dose above.
radioactive seed implantation:
a.the indications of percutaneous implantation of radioactive particles
(A)of breast lesions<5cm;ipsilateral axillary lymph nodes reach activities; without distant metastasis.
(B)can not accept due to various diseases due to various reasons, surgical resection or unwilling to undergo resection for palliative treatment of advanced patients.
b.implantation of radioactive particles in the technical process
According to B-films orCTimages, complete preoperative three-dimensional treatment planning(TPS)design, and calculate how much the particles of radioactive particles; in the breast skin surface to draw the appropriate location of the tumor, and calibration of the needle point, the needle direction and depth; in theCTorBultrasound-guided implantation of needle insertion; confirm correct implant position of the needle after the implantation of particles with the implantation of the gun; remove the implant needles and sterilization wrap; perspective or ultrasound with the number of particles shooting Duojiaoangle orientation film, verification of the actual particle position within the organization and distribution arrangement; testing the working environment (working full time protective doses are needed to monitor, record), the staff need protection in the operation.
c.local tumor excision and axillary lymph node dissection for seed implantation
Minimally invasive treatment of breast cancer indications:
Breast lesions<5cm;ipsilateral axillary lymph nodes reach activities; without distant metastasis.
""125 1Main processes: general anesthesia underwent local excision of breast mass and axillary lymph node dissection, after sweeping the size of the tumor bed based on the application, "sandwich" method planting125 1particles.