Cryoablation Safe, Well-Tolerated for Early-Stage Breast Cancer

Laurie Barclay, MD

May 10, 2004

May 10, 2004 — Cryoablation for early-stage breast cancer is safe and well tolerated, according to the results of a multi-institutional pilot study published in the May issue of the Annals of Surgical Oncology.

"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," write Michael S. Sabel, MD, from the University of Michigan in Ann Arbor, and colleagues. "This not only would improve cosmetic outcomes, but could also greatly decrease operating room and anesthesia needs, recovery times, surgical complications, and health-care costs."

Of 29 patients with ultrasound-visible primary invasive breast cancer not larger than 2.0 cm who were enrolled, 27 patients (93%) successfully underwent ultrasound-guided cryoablation, using a tabletop argon gas-based cryoablation system with a double freeze/thaw cycle. One to four weeks later, patients had standard surgical resection.

Cryoablation was successful in an office-based setting and required only local anesthesia, with no complications during the procedure or pain requiring narcotic pain medications after the procedure.

Cryoablation successfully destroyed all cancers smaller than 1.0 cm, but it was successful for tumors between 1.0 and 1.5 cm only in patients with invasive ductal carcinoma without a significant component of ductal carcinoma in situ (DCIS). For unselected tumors larger than 1.5 cm, cryoablation was not reliable using this technique. Most cryoablation failures were in patients with noncalcified DCIS.

"Cryoablation is a safe and well-tolerated office-based procedure for the ablation of early-stage breast cancer," the authors write. "At this time, cryoablation should be limited to patients with invasive ductal carcinoma ≤1.5 cm and with <25% DCIS in the core biopsy."

The investigators are planning a multicenter phase II clinical trial.

Ann Surg Oncol. 2004;11:542-549

Reviewed by Gary D. Vogin, MD

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