High intensity focused ultrasound in the treatment of breast fibroadenomata: Results of the HIFU-F feasibility trialObjectives: Breast fibroadenomata (FAD) are the most common breast lumps in women. High intensity focused ultrasound (HIFU) is a non-invasive ablative technique that can be used to treat FAD but is associated with prolonged treatment times. In the HIFU-F trial, we evaluated the change in volume over time with circumferential HIFU treatment of FAD and compare this to no treatment.Methods: Patients ≥18 years, diagnosed with symptomatic, palpable FAD, visible on ultrasound (US) were recruited. Twenty patients were treated using the US-guided-HIFU under local anaesthesia. Another 20 participants underwent an US six months after diagnosis. Outcome measures included: reduction in treatment time compared to whole lesion ablation; feasibility to achieve a 50% reduction in volume after six months; decrease in volume compared to a control group and reduction in symptoms.Results: Circumferential ablation reduced the mean treatment time by 37.5% (SD 20.1%) compared to whole lesion ablation. US demonstrated a significant mean reduction in FAD volume of 43.5% (SD 38.8%; p=0.016, paired t-test) in the HIFU group compared to 4.6% (SD 46.0%; p=0.530) in the control group after six months. This mean reduction in FAD volume between the two groups was significant in favour of the HIFU group (p=0.002, grouped t-test). Pre-treatment pain completely resolved in six out of eight patients six months post-treatment.Conclusion: Circumferential HIFU ablation of FAD is feasible, with a significant reduction in pain and volume compared to control participants. It provides a simple, non-invasive, outpatient -based alternative to surgical excision for FAD.ISRCTN registration: 76622747

The magnetic technique for SLNB is non-inferior to the standard technique, with a high identification rate but with a significantly higher lymph node retrieval rate.

Circumferential HIFU treatment for breast fibroadenomata is feasible to reduce both lesion size and treatment time. HIFU is a non-invasive alternative technique for the treatment of breast fibroadenomata. ISRCTN registration: 76622747.