A freezing technique typically used to eviscerate small cancerous tumors has been shown effective for breast cancer, even when the tumors are large. The brand-new research was presented this week at the Society of Interventional Radiology (SIR) Annual Scientific Meeting in Salt Lake City, Utah.
Cryoablation is a minimally invasive procedure that relies on imaging guidance, typically from an ultrasound or CT scanner. A small probe is inserted into an area around a tumor, freezing it and ideally killing the cancer cells.
The study marks one of the first instances of the technique being used inside breasts. A research team led by Jolie Jean, MD, from Weill Cornell Medicine, who also co-presented the findings at the SIR meeting, assessed outcomes for 60 patients who underwent cryoablation as an alternative to surgery for breast cancer.
Of the cohort, 48 had invasive ductal carcinoma, five had invasive lobular carcinoma and seven patients had other histology. All were poor candidates for surgery due to their age, cardiac health, or because they were currently undergoing chemotherapy. Tumor sizes had an average of 2.5 cm, with some as large as 9 cm.
Cryoablation was performed with either local anesthesia or minimal sedation, based on patient preference. Each procedure lasted between 10 and 18 minutes, from freeze to thaw, followed by an additional, more intensive cryo-freezing that lasted another 5 to 10 minutes. For all 60 patients, the outpatient procedure allowed them to return home within a few hours after monitoring their response to the second blast of cold.
Patients with tumors larger than 1.4 cm were treated with multiple probes (one probe placement per centimeter of disease). In 16 months, the recurrence rate of breast cancer, even for large tumors, was 10%.
The research team said this is not intended to replace surgery, but the results are promising. Patients continue to be monitored over a long period of time for signs of cancer recurrence.
"For patients who have larger tumors but can't undergo surgery, this approach could be more effective than the current standard of care for patients who are not surgical candidates," Yolanda Bryce, MD, an interventional radiologist at Memorial Sloan Kettering Cancer Center and co-presenter for the study, said in a statement. "When treated with only radiation and hormonal therapy, tumors will eventually return. So, the fact that we saw only a 10% recurrence rate in our study is incredibly promising."
Future research is necessary to understand how a combination of treatments with cryoablation can further improve outcomes.
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