Cryoablation: A promising non-operative therapy for low-risk breast cancer

Habrawi, Zaina; Melkus, Michael W.; Khan, Sonia Y.; Henderson, James D.; Brandi, Luis; Chu, Victoria; Rahman, Rakhshanda Layeequr

doi:10.1016/j.amjsurg.2020.07.028

Cited by 32 publications

(22 citation statements)

References 28 publications

(28 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Cryosurgery demonstrates high potential in oncology, in particular, to remove neoplasms and metastases of different localizations, such as liver, 37 breast, 55 lungs, 40 prostate, 56 kidney, 57 stomach, 58 and skin. 59 Considering the ability of THz technologies for tumor diagnosis along with currently developing THz instruments and methods for healthy and pathological tissues differentiation, 2 the combination of THz preoperative characterization of tissue with further TPS-controlled cryoablation could become an effective tool for oncology.…”

Section: Resultsmentioning

confidence: 99%

In situ terahertz monitoring of an ice ball formation during tissue cryosurgery: a feasibility test

et al. 2021

View full text Add to dashboard Cite

Significance: Uncontrolled cryoablation of tissues is a strong reason limiting the wide application of cryosurgery and cryotherapy due to the certain risks of unpredicted damaging of healthy tissues. The existing guiding techniques are unable to be applied in situ or provide insufficient spatial resolution. Terahertz (THz) pulsed spectroscopy (TPS) based on sensitivity of THz time-domain signal to changes of tissue properties caused by freezing could form the basis of an instrument for observation of the ice ball formation.Aim: The ability of TPS for in situ monitoring of tissue freezing depth is studied experimentally.Approach: A THz pulsed spectrometer operated in reflection mode and equipped with a cooled sample holder and ex vivo samples of bovine visceral adipose tissue is applied. Signal spectrograms are used to analyze the changes of THz time-domain signals caused by the interface between frozen and unfrozen tissue parts.Results: Experimental observation of TPS signals reflected from freezing tissue demonstrates the feasibility of TPS to detect ice ball formation up to 657-μm depth.Conclusions: TPS could become the promising instrument for in situ control of cryoablation, enabling observation of the freezing front propagation, which could find applications in various fields of oncology, regenerative medicine, and THz biophotonics.

show abstract

Section: Resultsmentioning

confidence: 99%

In situ terahertz monitoring of an ice ball formation during tissue cryosurgery: a feasibility test

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Cryoablation of breast cancer provides a viable alternative to traditional resection and thermal ablation where the tumor undergoes a series of freeze/thaw cycles but remains within the patient. 35 As the ''killed'' tumor and surrounding tissue architecture is preserved, there remains the potential for augmentation of an immune response to the preserved TAAs (potentially measurable by TIL scoring), 24 leading to an abscopal effect. This aligns with our findings of increased stromal and invasive margin TILs in the unmanipulated distant tumors 1 week after local therapy of primary tumor, with a significant increase for stromal and invasive margin TILs in the cryoablation group.…”

Section: Discussionmentioning

confidence: 99%

“…More importantly, by removing the TAAs, resection denies an opportunity for the immune system to mount a robust response needed to overcome the potential for targeting metastasis. Cryoablation is clinically used for the treatment of fibroadenomas and low-risk cancers, [35][36][37][38][39] mainly because of convincing evidence supporting complete destruction of tumors up to 15 mm in size. However, the potential of augmented immune response by virtue of leaving TAAs in vivo, is not very well-leveraged in the present day practice.…”

Section: Discussionmentioning

confidence: 99%

Tumor-Infiltrating Lymphocytes (TILs) as a Biomarker of Abscopal Effect of Cryoablation in Breast Cancer: A Pilot Study

et al. 2022

Self Cite

View full text Add to dashboard Cite

Background Morphological evaluation of tumor-infiltrating lymphocytes (TILs) in breast cancer is gaining momentum as an immunological biomarker. This experiment evaluates the role of TILs in distant tumors as a measure of abscopal effect from cryoablation of breast cancer. Methods BALB/c mice underwent bilateral orthotopic transplant with 4T1-12B (triple-negative) cells. At 2 weeks, left tumors were treated by either resection (standard of care group) or cryoablation (intervention group) followed by resection of the distant right tumors 1 week posttreatment. TIL scores were calculated from hematoxylin and eosin-stained sections and phenotyped for cytotoxic T-lymphocyte (CTL) markers by immunofluorescence. Primarily resected tumors served as baseline (Tbaseline), whereas resected distant right-sided served as the readout for abscopal effect (AbsRes or AbsCryo). Mice were monitored for tumor recurrence and metastasis. Results The AbsCryo had a significant mean (SD) increase in stromal (2.8 [1.1]%; p = 0.015) and invasive margin TILs (50 [12]%; p = 0.02) compared with TBaseline (1.0 [0]% and 31 [4.9]%, respectively). CTL phenotyping revealed a significant increase in mean (SD) CD8+ T cells (15.7 [12.1]; p = 0.02) and granzyme B (4.8 [3.6]; p = 0.048) for the AbsCryo compared with TBaseline (5.2 [4.7] and 2.4 [0.9], respectively). Posttreatment, the cryoablation group had no recurrence or metastasis, whereas the resected group showed local recurrence and lung metastasis in 40% of the mice. Postprocedure increase in TIL score of distant tumors was associated with decrease in tumor relapse (p = 0.02). Conclusions Cryoablation induced a robust tumor-specific TIL response compared with resection, suggesting an abscopal effect leading to the prevention of cancer recurrence and metastasis.

show abstract

“…Hence, one of the main features of CA is the ability to clearly see where the tissue is affected by the treatment. This procedure has been firstly described in 1985 24,25 and, thanks to the more recent technical improvements, can be now applied through small and easily handling cryo‐probes, powered by argon or liquid nitrogen. Compared to heat‐based techniques, cryoablation is painless, low temperatures being analgesic.…”

Section: Percutaneous Treatment Of Breast Cancermentioning

confidence: 99%

Interventional oncology in breast cancer

Orsi

2023

J Med Imag Rad Onc

View full text Add to dashboard Cite

Breast cancer (BC) is the most common cancer and one of the most important causes of death in women. Surgery is the standard therapy for breast cancer and in the last decades evolved towards a more conservative approach, with lumpectomy, followed by radiation therapy, the most common option. Unfortunately, up to 40% of women affected by BC will develop metastases and will receive systemic therapy, which improves survival and quality of life. Interventional oncology (IO), thanks to the improvement in technology and clinical experience, is gaining an important role in the field of breast cancer, both in treating the primary tumour and also in metastasis in well‐selected cases. Percutaneous thermal ablation and more recently cryoablation are reported to achieve promising results in the radical treatment of small breast cancer, with optimal cosmetic outcome and a very high safety profile. Percutaneous ablation as well as intra‐arterial therapies, such as chemoembolization and radioembolization, might also be indicated in metastatic BC patients. In advanced stage disease, breast cancer liver metastases (BCLM) represent the main factor affecting the overall survival. Metastatic breast disease is a systemic disease, with tumour deposits potentially spread into different organs and tissues for which systemic therapy is the standard approach. Local therapies for liver metastases might have an important role in improving survival and quality of life in well‐selected patients. Clinical and technical indications with their limitations, results and potential complications in local IO treatment for BCLM, will be also described.

show abstract

Cryoablation: A promising non-operative therapy for low-risk breast cancer

Cited by 32 publications

References 28 publications

In situ terahertz monitoring of an ice ball formation during tissue cryosurgery: a feasibility test

In situ terahertz monitoring of an ice ball formation during tissue cryosurgery: a feasibility test

Tumor-Infiltrating Lymphocytes (TILs) as a Biomarker of Abscopal Effect of Cryoablation in Breast Cancer: A Pilot Study

Interventional oncology in breast cancer

Contact Info

Product

Resources

About