Cryotherapy for Breast Cancer: A Feasibility Study without Excision

Abstract

PURPOSE To assess the feasibility of percutaneous multiprobe breast cryoablation (BC) for diverse presentations of cancers that remained in situ after BC. MATERIALS AND METHODS After breast magnetic resonance (MR) imaging and thorough consultation, patients underwent BC after giving informed consent. This study was approved by the institutional review board. In 12 BC sessions, 22 breast cancer foci (stages I–IV) were treated in 11 patients who refused surgery by using multiple 2.4-mm cryoprobes. Five patients had recurrent disease and six had new diagnoses. With use of only local anesthesia, six patients were treated with ultrasonographic (US) guidance and five were treated with both computed tomographic (CT) and US guidance. Saline injections and warming bags were used to protect the skin. Procedure success was defined as 1 cm visible ice beyond all tumor margins. MR imaging and/or clinical follow-up were available for up to 72 months after BC. RESULTS US produced sufficient ice visualization for small tumors, whereas CT helped confirm overall ice extent. The mean pretreatment breast tumor diameter was 1.7 cm ± 1.2 (range, 0.5–5.8 cm), and an average of 3.1 cryoprobes produced 100% procedural success with mean ice diameters of 5.1 cm ± 2.2 (range, 2.0–10.0 cm). No significant complications, retraction, or scarring were noted. Biopsies at the margins of the cryoablation site immediately after BC and at follow-up were all negative. No local recurrences have been noted at an average imaging follow-up of 18 months. CONCLUSIONS In conjunction with thorough pre- and postablation MR imaging, CT/US-guided multiprobe BC safely achieved 1 cm visible ice beyond tumor margins with minimal discomfort, good cosmesis, and no short-term local tumor recurrences.

Percutaneous local ablation of unifocal subclinical breast cancer: clinical experience and preliminary results of cryotherapy

“…Currently, no diagnostic tool ensures optimal demonstration and follow-up of the in situ ablation, so we can consider this method as primary therapy for breast cancer. Recently, a study [17] showed the feasibility of multiprobe percutaneous breast cryoablation (BC) for different presentations of cancers, that remained in situ after BC, without surgery excision and with MR imaging and/or clinical follow-up available for up to 72 months after BC. In our study, correlating the ablated volume or the obtained necrosis, through the dimensional data calculated by MRI and the one calculated by histological sample, we noted a dimensional overestimation on MRI assessment in comparison with histopathology.…”

Non-surgical therapy and radiologic assessment of stage I breast cancer treatment with novel enzyme-targeting radiosensitization: Kochi Oxydol-Radiation Therapy for Unresectable Carcinomas, type II (KORTUC II)

“…however, breast conserving surgery often degrades the cosmetic outcome to some degree. therefore, various types of minimally invasive options have been employed as alternatives to surgical therapy, such as radiofrequency ablation (rFa) (5,6), focused ultrasound ablation (FuS) (3,4) and cryotherapy (7). these minimally invasive approaches are currently being investigated.…”

“…thus, nowadays, local control is expected to be minimally invasive on the basis that permanent curability is estimated to be comparable. Various types of non-surgical ablation have been introduced as a local control for early breast cancer that also achieve cosmetic gains (3)(4)(5)(6)(7). a new enzyme-targeting radiosensitization treatment containing hydrogen peroxide and sodium hyaluronate for percutaneous injection, kochi Oxydol-radiation therapy for unresectable carcinomas, type ii (kOrtuc ii) (8), was recently developed.…”

Minimally invasive ablative techniques in the treatment of breast cancer: a systematic review and meta-analysis

“…A total of 63 articles matched the selection criteria. The 63 articles included 16 feasibility studies [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28], 12 phase I studies [29][30][31][32][33][34][35][36][37][38][39][40], nine phase II studies [41][42][43][44][45][46][47][48][49], three comparative studies [50][51][52], one retrospective study [53], and four randomised controlled trials [54][55][56]. In 18 studies the type of study was not reported [8,[57][58][59][60][61][62][63][64]…”