Office-based ultrasound-guided cryoablation of breast fibroadenomas

Kaufman, Cary S.; Bachman, Barbara; Littrup, Peter J.; White, Michael; Carolin, Kathryn A; Freman-Gibb, Laurie A; Francescatti, Darius; Stocks, Lewis H.; Smith, J. Stanley; Henry, Caitlin; Bailey, Lisa; Harness, Jay K.; Simmons, Rache M.

doi:10.1016/s0002-9610(02)01010-3

Cited by 115 publications

(67 citation statements)

References 18 publications

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“…26 -29 Cryosurgery has been successfully used for the ablation of tumors in the liver, 30,31 prostate, 32,33 and kidney 34,35 ; the palliative treatment of locally advanced breast cancers 36,37 ; and the treatment of breast fibroadenomas. 38 The ability to clearly visualize the forming ice ball with ultrasound provides outstanding precision and control for this procedure. With the recent improvements in breast imaging, our ability to visualize, take biopsy samples from, and treat breast tumors has markedly improved.…”

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confidence: 99%

Cryoablation of Early-Stage Breast Cancer: Work-in-Progress Report of a Multi-Institutional Trial

et al. 2004

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Background: With recent improvements in breast imaging, our ability to identify small breast tumors has markedly improved, prompting significant interest in the use of ablation without surgical excision to treat early-stage breast cancer. We conducted a multi-institutional pilot safety study of cryoablation in the treatment of primary breast carcinomas.Methods: Twenty-nine patients with ultrasound-visible primary invasive breast cancer Յ2.0 cm were enrolled. Twenty-seven (93%) successfully underwent ultrasound-guided cryoablation with a tabletop argon gas-based cryoablation system with a double freeze/thaw cycle. Standard surgical resection was performed 1 to 4 weeks after cryoablation. Patients were monitored for complications, and pathology data were used to assess efficacy.Results: Cryoablation was successfully performed in an office-based setting with only local anesthesia. There were no complications to the procedure or postprocedural pain requiring narcotic pain medications. Cryoablation successfully destroyed 100% of cancers Ͻ1.0 cm. For tumors between 1.0 and 1.5 cm, this success rate was achieved only in patients with invasive ductal carcinoma without a significant ductal carcinoma-in-situ (DCIS) component. For unselected tumors Ͼ1.5 cm, cryoablation was not reliable with this technique. Patients with noncalcified DCIS were the cause of most cryoablation failures.Conclusions: Cryoablation is a safe and well-tolerated office-based procedure for the ablation of early-stage breast cancer. At this time, cryoablation should be limited to patients with invasive ductal carcinoma Յ1.5 cm and with Ͻ25% DCIS in the core biopsy. A multicenter phase II clinical trial is planned.

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Cryoablation of Early-Stage Breast Cancer: Work-in-Progress Report of a Multi-Institutional Trial

et al. 2004

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“…9 Others have shown that cryoablation is highly successful in treating fibroadenomas and other benign breast lesions. [10][11][12][13][14][15] In 2001, the Visica™ system for cryoablation of fibroadenomas was approved by the US Food and Drug Administration (FDA). 16,17 Cryoassisted lumpectomy is another application of this technique for the localization and removal of non-palpable breast lesions.…”

Section: R Y O a B L A T I O N To D A Ymentioning

confidence: 99%

“…13,17,20 A small incision is made after local anesthesia for probe insertion and a cryoprobe is placed in the center of the lesion using the guidance of the ultrasound.The procedure is performed with the patient awake. 10 The cryoprobe is insulated and is directly placed within the tumor (except for the exposed tip).…”

Section: T H E U S E O F C R Y O a B L A T I O Nmentioning

confidence: 99%

“…While the freezing procedure itself generates anesthesia to the breast tissue 29 it allows the procedure to be an office-based modality. 10,15 Cryoablation-induced anesthesia differs from heat-based tissue destruction in that the latter causes enough discomfort to require general anesthesia or significant IV sedation to be provided in an operating room (OR). The need for narcotics for post-operative pain is minimal.…”

Section: T H E a D V A N T A G E S A N D D I S A D V A N T A G E S O mentioning

confidence: 99%

“…The need for narcotics for post-operative pain is minimal. 10,20,35 This procedure is easily followed by ultrasound, because the proximal edge of the ice ball is clearly visible as a hyperechoic rim, 29 which therefore permits skin protection. It should be mentioned that although the ultrasound clearly shows the freezing process the posterior acoustic shadowing prevents imaging of the interior of the ice ball and the area posterior to it, not allowing a precise measurement of the exact size of the ice ball and the distance to the chest wall.…”

Section: T H E a D V A N T A G E S A N D D I S A D V A N T A G E S O mentioning

confidence: 99%

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