Removing a Fibroadenoma with Laser Therapy

Information and Insights About a Minimally Invasive Procedure

Novilase Laser Ablation for Breast Fibroadenomas
Novilase Laser Ablation for Breast Fibroadenomas. Art © Pam Stephan

Breast fibroadenomas, usually removed surgically, can also be removed with a laser during a procedure called laser ablation therapy. 

Let's learn more about this procedure, including insight from a breast surgeon and a patient.

What is a Breast Fibroadenoma?

Fibroadenomas are benign breast tumors that are usually not bothersome unless they are large or near the breast skin. Breast fibroadenomas may be felt during your breast self-exam as smooth, flexible lumps.

On a mammogram, these may look like cysts or a well-contained tumor.

If you are over 40 years old and have one or more painful or growing fibroadenomas, many doctors recommend having them removed. 

What is Laser Ablation Therapy?

Novilase is the first breast procedure to use laser ablation therapy to remove fibroadenomas — it uses an ultrasound-guided laser device to destroy the fibroadenoma, leaving behind only a tiny scar, no sutures, and no change in breast shape. 

In terms of the actual Novilase procedure, a hollow probe is inserted into the center of your fibroadenoma, and then a laser fiber is threaded into the probe. A temperature probe will be inserted nearby to monitor the laser's heat. The laser heats your benign tumor while your surgeon watches the temperature on a nearby monitor. When the fibroadenoma has been destroyed, the probes are removed, and a small bandage is placed over the skin.

It's an outpatient procedure, completed in about 30 minutes, with local anesthesia, and there is rapid recovery.

A Surgeon's Perspective on Laser Ablation for Benign Breast Tumors

Dr. Colleen Hagen, a general surgeon with Midwest Surgical Associations, was interviewed in 2009 regarding laser ablation.

She stated, "some women have multiple fibroadenomas, and when they want them surgically removed, it's like doing a mastectomy in bits and pieces." Novilase is much easier on women than a lumpectomy, particularly if there is more than one fibroadenoma. "I want to get the word out to my referring primary care physicians, gynecologists, and radiologists that this is an option," said Dr. Hagen.

A Patient's Perspective on Laser Ablation for Benign Breast Tumors

Judy G. had the Novilase procedure and said that it exceeded her expectations. She had already been through two painful surgical biopsies with general anesthesia and slow recovery. Following her laser ablation procedure, she said, "I felt good enough after having the procedure done to walk back to my hotel and (later) take a mile-long walk! I was not able to do this after having my biopsy done." J.G. remarked that in contrast to a lumpectomy, the laser ablation did not change her breast shape and caused very little pain. "I also am very pleased with the fact that there is basically no scar at all!" 

Advantages and Drawbacks of Laser Ablation of Fibroadenomas

When compared with lumpectomy, laser ablation appears to win out with many patients. Since you have only a small nick in your skin, there's less risk of infection. You won't need general anesthesia, sutures, surgical drains, or more than a day for recovery. Instead of a two- or three-inch scar, you will have a tiny scratch on your breast. The shape of your breast won't change, as healthy tissue overtakes the lasered fibroadenoma tissue. 

Novilase is FDA-cleared for fibroadenomas up to 2 cm, but such benign tumors can grow up to 15 cm (5.9 inches) - and it is not yet known whether laser ablation will be effective on larger fibroadenomas.

Scientific Study on Novilase

There is currently a study going on that is monitoring the long-term safety and effectiveness of the Novilase laser therapy for benign breast conditions, like fibroadenomas and papillomas. It's called the American Breast Laser Albation Therapy Evaluation (ABLATE) study.

This is helpful because it will tease out the pluses and minuses of the procedure and help surgeons determine which patients are best suited for this therapy. 

What Should I Do?

If you have a fibroadenoma that needs to be removed, be sure to discuss the different options available. While laser ablation is a less invasive therapy, it may or may not be the right choice for you. 

Sources:

Personal correspondence with Dr. Colleen Hagen, December 11, 2009.

Personal correspondence with J,G. December 15, 2009.

American Breast Laser Ablation Therapy Evaluation (ABLATE) ClinicalTrials.gov, U.S. National Institutes of Health. Accessed: December 27, 2009.

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