The statistics are staggering. One in seven women will develop breast cancer during her lifetime. That’s your wife. Your daughter. Your sister. Your friend. Or – if you’re like Glenda Hill – that’s you.

Hill, administrative assistant to the chairman of emergency medicine at UAMS, was diagnosed with breast cancer on Dec. 17, 2004. Three weeks later, she became one of the first patients to undergo a new procedure developed at the UAMS Arkansas Cancer Research Center (ACRC) – radiofrequency ablation-assisted lumpectomy (RFA). 

Developed under the leadership of Dr. V. Suzanne Klimberg, RFA is the result of more than three years research on how to reduce both the need for follow-up surgery and the rate of local breast cancer recurrence. Klimberg is the director of breast surgical oncology and professor of surgery at UAMS and leads the university’s Breast Team of surgeons, pathologists, medical oncologists and radiation oncologists. The Breast Team takes the team approach literally by meeting once a week to discuss complicated and challenging cases. The meetings are broadcast throughout the state giving local doctors the chance to interact with the UAMS team.

Hill couldn’t be more pleased with her RFA experience. “I can hardly tell I even had surgery,” she said. “I had very little scarring. The recovery was minimal, and I hardly had any swelling or pain.”

Most commonly at UAMS, RFA is used to treat liver cancer, but also has been shown effective in treating malignant and benign tumors in other areas of the body. UAMS is the first hospital to use RFA-assisted lumpectomy to treat breast cancer.  The idea is simple: Remove the cancer first, then create a cancer-free zone around the area where the tumor was removed. To do this, Klimberg came up with the idea to sear – or ablate – one centimeter of tissue around the lesion.

“Radiation kills tissue slowly, so why not kill it quickly by cooking it? It makes perfect sense, and this is a very safe thing to do,” Klimberg said. 

After their initial lumpectomy, 40 percent of breast cancer patients have to go back to surgery to remove cancer that was left behind. With RFA, the remaining cancer – which may be too small for most diagnostic tools to detect – is effectively obliterated from the body, eliminating the need for a second surgery.

The RFA-assisted lumpectomy begins with standard removal of the tumor. Then, an RFA probe is inserted and heated to 100 degrees for 15 minutes, creating a one centimeter moat of dead tissue around the cavity. “Ninety percent of local breast cancer recurrences are at the site of the original tumor. By using RFA, if decreases your rate of recurrence,” Klimberg said. 

One of the most exciting aspects of RFA is the fact that it may prevent the need for radiation therapy in some patients, including Hill. “With RFA, I had my ‘radiation’ during surgery, and I still had my breast,” she said. “You couldn’t look at me and tell I was a cancer patient. I like that.”

Advances in Reconstruction
For cancer patients who either require or opt for a mastectomy, breast reconstruction options now are better than ever. “The developments in the past three years have been tremendous,” said Dr. Julio Hochberg, a plastic surgeon at the ACRC and professor of surgery in the UAMS Division of Plastic and Reconstructive Surgery.

Hochberg was recently invited to present his innovative techniques at the 21st Regional Brazilian South Congress of Plastic Surgery in Gramado, Brazil. Among his advances are the use of Botox to reduce pain after mastectomy and the use of AlloDerm – or human cadaver tissue – in reconstructive surgery.

Alloderm has been used successfully in many procedures, including the treatment of hernias, skull surgeries and trachea reconstruction. UAMS is the first hospital to use it for breast reconstruction in conjunction with the use of tissue expanders.

After the Alloderm is removed from the donor, it is put through a treatment to eliminate its cells. When surgically attached to live tissue on the cancer patient, the Alloderm becomes repopulated with new cells. “It comes back to life or is resurrected,” Hochberg said.

In the reconstruction process, tissue expanders are placed under the chest muscle. In many patients the muscle isn’t large enough to cover the expander and flaps must be constructed from the muscles on the side of the breast. This produces additional bleeding and pain for the patient, Hochberg said.

To alleviate this problem, Hochberg uses Alloderm to provide complete coverage of the implant and avoid additional incisions. The procedure takes only about 12 minutes.
“It’s less dissection, less bleeding and it’s definitely less painful because you don’t cut more tissue,” he said.

Hochberg also uses Botox, most commonly known for its ability to reduce wrinkles, as a pain-relieving method during and after surgery. By injecting low doses of Botox into the muscle during surgery, spasms after surgery are reduced and pain is diminished. “The muscle wasn’t made for breast reconstruction. When it moves, it causes pain. Given in low doses, Botox diminishes the action and reduces the spasm,” Hochberg said.

To read more about the Arkansas Cancer Research Center, visit www.acrc.uams.edu.