Improvements in breast imaging have resulted in breast cancers being diagnosed at earlier stages when the tumors are smaller than 1 cm in diameter. Treatment of such cancers with total mastectomy and extensive lymph node dissection are no longer considered appropriate. Breast conservation therapies such as lumpectomies and sentinel node biopsies are becoming the accepted norm. With the support of the Mary Kay Ash Charitable Foundation and the Bears Care Foundation, we have been working on a pilot study of a new technique for treating these small breast tumors.
The stereotactic method has now been used for over a decade to accurately diagnose breast cancer by needle. We are now using this very precise method of pinpointing breast lesions to visualize and then treat the breast cancer with laser energy.
This procedure, which we have called Interstitial Laser Therapy (ILT), is as follows: First, the diagnosis of cancer is made by needle samples obtained from the breast tumor using stereotactic or ultrasound guidance. On the next visit, the patient lies on the stereotactic table and, under local anesthesia with some IV sedation, the breast tumor is revisualized and then treated with laser energy delivered through an optic fiber to its center. Our prior experiments with animals as well as patients with cancer of the liver have shown how much energy is necessary to destroy the cancer cells completely. We now know that when the temperatures at the periphery of the tumor reached 60° Celsius or 140° Fahrenheit, all cancer cells have been destroyed. With our prototype device, we are now able to safely and precisely deliver laser energy as well as monitor the heated tumor for successful therapy. We plan to treat more patients with small tumors with this method followed by lumpectomy to ensure that we have achieved 100% tumor destruction as reported by pathology.
Once we are confident that we can achieve this every time, we will begin to treat these small breast cancers without surgical removal. The laser-treated, dead cancer cells are absorbed by the body and become scar tissue. These patients will then undergo radiation therapy to the breast as is the standard, but will also be closely followed for several years by PET scan, mammography, and if necessary, needle biopsy to ensure tumor destruction.
Advantages are: reduced pain and disfigurement, as well as shorter recovery time.